{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T17:26:07Z","timestamp":1786987567796,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Transesophageal echocardiography (TEE) is the standard periprocedural imaging modality for atrial fibrillation (AF) catheter ablation but carries the burden of esophageal instrumentation, frequent deep sedation, and logistical constraints. Intracardiac echocardiography (ICE) is a growing alternative, yet comparative evidence had not been systematically synthesized. This systematic review and meta\u2010analysis compared ICE and TEE as periprocedural imaging strategies in adults undergoing AF catheter ablation, focusing on safety and procedural efficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A search of PubMed, Embase, CENTRAL, and Web of Science identified six eligible studies (five cohort studies and one multicenter randomized controlled trial) enrolling 4760 participants (ICE\n                      <jats:italic>n<\/jats:italic>\n                      = 2616; TEE\n                      <jats:italic>n<\/jats:italic>\n                      = 2144). Peto odds ratios (OR) were used for dichotomous safety outcomes and mean differences (MD) with random\u2010effects models for continuous outcomes; certainty of evidence was graded using GRADE.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>ICE was not associated with significant differences in periprocedural complications, including cardiac tamponade (Peto OR 0.67, 95% CI 0.33\u20131.36), stroke\/TIA\/thromboembolism (0.81, 0.36\u20131.78), vascular complications (1.22, 0.70\u20132.13), or bleeding (0.50, 0.22\u20131.12). Total procedure duration did not differ (MD \u22127.11 min, 95% CI \u221218.82 to 4.61). ICE was associated with shorter fluoroscopy time (MD \u22124.17 min, \u22126.07 to \u22122.26), though this was attenuated after excluding studies with combined left atrial appendage occlusion. Certainty of evidence was low to very low; the absence of significant differences reflects imprecision rather than demonstrated equivalence and should be regarded as hypothesis\u2010generating.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Within these limitations, ICE may be a reasonable alternative to TEE in appropriately selected patients at centers with established ICE expertise. PROSPERO: CRD420251239269.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70543","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T12:35:37Z","timestamp":1782995737000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intracardiac Echocardiography Versus Transesophageal Echocardiography for Guidance of Atrial Fibrillation Ablation: A Systematic Review and Meta\u2010Analysis of Procedural Safety and Efficacy"],"prefix":"10.1111","volume":"43","author":[{"given":"Afthab Salam","family":"Kanniyan","sequence":"first","affiliation":[{"name":"Government Medical College  Kozhikode Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Government Medical College  Kozhikode Kerala India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arshita","family":"Wadhwa","sequence":"additional","affiliation":[{"name":"Shri Atal Bihari Vajpayee Medical College and Research Institute  Bangalore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sruthi Sai Purnima","family":"Koduri","sequence":"additional","affiliation":[{"name":"JSS Medical College  Mysore India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimrah","family":"Fatima","sequence":"additional","affiliation":[{"name":"Ayaan Institute of Medical Sciences  Hyderabad Telangana India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshan Shivanne","family":"Gowda","sequence":"additional","affiliation":[{"name":"Hassan Institute of Medical Sciences  Hassan Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Marcela","family":"Romero\u2010Acero","sequence":"additional","affiliation":[{"name":"Cardiac Care and Vascular Medicine Albert Einstein College of Medicine  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Nanna","sequence":"additional","affiliation":[{"name":"Cardiac Care and Vascular Medicine Albert Einstein College of Medicine  New York City New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelby","family":"Kutty","sequence":"additional","affiliation":[{"name":"BayCare Health System  Clearwater Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"issue":"12","key":"e_1_2_10_2_1","first-page":"1249","article-title":"Intracardiac vs Transesophageal Echocardiography in Atrial Fibrillation Ablation","volume":"10","author":"Hu X.","year":"2025","journal-title":"Journal of the American Medical Association Cardiology"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001193"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.04.069"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/hc5001.101503"},{"issue":"3","key":"e_1_2_10_7_1","first-page":"iii42","article-title":"Intracardiac Echocardiography During Catheter Ablation of Atrial Fibrillation","volume":"10","author":"Saliba W.","year":"2008","journal-title":"Europace"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.22675"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8175.2012.01819.x"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.000504"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2024.03.017"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-017-0607-1"},{"issue":"5","key":"e_1_2_10_13_1","article-title":"Atrial Fibrillation Ablation: Impact of Intracardiac Echocardiography on Reduction of Procedure Time and Hospitalization [in Portuguese]","volume":"120","author":"Sant'Anna R. 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