Intracardiac Versus Transesophageal Echocardiography for diagnosis of
left atrial appendage thrombosis in atrial fibrillation: A Meta-analysis
Abstract
Introduction: Patients with atrial fibrillation excluded left atrial
appendage(LAA) thrombosis is typically performed utilizing
transesophageal echocardiography (TEE).Intracardiac echocardiography
(ICE) can be a suitable alternative to detect thrombosis. Methods: We
searched PubMed ,Cochrane Library and Embase for published abstracts and
manuscripts until for published abstracts and manuscripts until June1,
2020. Studies reporting clinical outcomes comparing TEE vs. ICE for LAA
thrombosis in human subjects aged ≥ 18 years were included. Two
investigators independently extracted the data and individual quality
assessment was performed. Analysis was performed using RevMan 5.3, STATA
15 and Meta-Disc 1.4. Results: Eight eligible studies consisting of 1108
patients (TEE = 558 vs. ICE = 550) were included. The average
sensitivity of ICE and TEE to diagnose left atrial appendage thrombosis
was 1.0 (95% CI: 0.91-1.00) vs 0.68 (95% CI: 0.49-0.83). The average
specificity of ICE and TEE diagnosis of left atrial appendage thrombosis
was 1.0 (95% CI: 0.99-1.00) vs 0.98 (95% CI: 0.96-0.99) . The AUC of
ICE and TEE were 0.9846 (SEAUC = 0.0196) and 0.9655 (SEAUC = 0.0401),
and the Q * statistics were 0.9462 (SEQ * = 0.0406) and 0.9127 (SEQ * =
0.0616), respectively. Z test was performed on Q * statistics (Z = 0.45,
P> 0.05), there was no significant difference between ICE
and TEE. Conclusion: ICE and TEE have similar diagnostic efficacy for
left atrial appendage thrombosis, but ICE has higher sensitivity and
specificity, which has certain advantages over TEE and has clinical
application prospects