Intracardiac Echocardiography-guided Left Atrial Appendage Occlusion. 2024

Juan Carlos Diaz, and Mauricio Duque, and Jorge Marin, and Julian Aristizabal, and Cesar Niño, and Oriana Bastidas, and Carlos D Matos, and Carolina Hoyos, and Daniela Hincapie, and Jorge E Romero
Cardiac Arrhythmia and Electrophysiology Service, Clinica Las Vegas, Universidad CES Medical School Medellin, Colombia.

Left atrial appendage occlusion (LAAO) is a suitable alternative to oral anticoagulant therapy to prevent stroke in patients with AF. Most procedures are performed under transoesophageal echocardiography (TOE) guidance, which facilitates transseptal puncture, reduces the risk of procedurerelated complications and provides an additional method for device selection and real-time monitoring during device deployment. However, TOE has significant shortcomings, including the need for general anaesthesia/deep sedation as well as a significant risk of procedure-related adverse events. More recently, intracardiac echocardiography has been proposed as an alternative to TOE guidance during LAAO procedures. In this review, we summarise the available evidence as well as providing a step-by-step approach for intracardiac echocardiography-guided LAAO.

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