Intracardiac Versus Transesophageal Echocardiography for Left Atrial Appendage Occlusion Combined With Radiofrequency Ablation
Intracardiac Versus Transesophageal Echocardiography for Left Atrial Appendage Occlusion Combined With Radiofrequency Ablation
A total of 60 patients with atrial fibrillation were scheduled to receive left atrial
 appendage occlusion combined with radiofrequency ablation, which were divided into two
 groups. The operation was performed under the guidance of intracardiac echocardiography and
 transesophageal echocardiography respectively (allocation ratio 1:1). During the operation,
 the total amount of contrast medium injected, the fluoroscopy time and the time from femoral
 vein puncture to transseptal puncture to closure were recorded in all patients. All patients
 underwent transesophageal echocardiography before and 3 months after operation, and the
 results were explained by two experienced ultrasound doctors to measure the presence of left
 atrial thrombus, residual shunt and device-related thrombus. All patients were examined by
 transthoracic echocardiography 3 months after operation to evaluate new pericardial effusion,
 pericardial tamponade, instrument embolization / displacement and so on. The baseline
 clinical and surgical features and hospitalization outcomes of patients guided by ICE and TEE
 were recorded and compared. Clinical endpoints include death, new pericardial effusion that
 does not require pericardiocentesis, tamponade with pericardiocentesis, instrument embolism /
 displacement, bleeding at the entry site, thromboembolic events (stroke / transient ischemic
 attack [TIA]), and renal failure requiring dialysis. The purpose of this study was to
 evaluate the feasibility, safety and effectiveness of intracardiac echocardiographic
 (ICE)-guided and transesophageal echocardiographic (TEE)-guided left atrial appendage
 occlusion combined with radiofrequency ablation. And try to analyze whether intracardiac
 echocardiography can be used as an alternative to transesophageal echocardiography in
 transcatheter closure of left atrial appendage. The average follow-up time was 1 year.
Inclusion Criteria:

 sustained AF attack occurred in patients with a duration of more than one year, patients
 taking class I and class III antiarrhythmic drugs could not prevent AF, patients younger
 than 80 years old Cha2ds2-vasc score ≥2, not suitable for long-term oral anticoagulant
 drugs.

 Exclusion Criteria:

 Patients with a history of atrial thrombosis or valvular heart disease (moderate or severe
 valve stenosis or severe valve regurgitation), patients undergoing prosthetic heart valve
 replacement, pregnant women, patients with previous liver and kidney diseases, malignant
 tumors or blood system diseases.