2.1 Study design and patient population
All consecutive NVAF patients at high risk of stroke (CHA2DS2-VASc scores≄2) underwent LAmbre (Lifetech Scientific, Shenzhen, China) occluders implantation at the First Affiliated Hospital of Wenzhou Medical University from August 2018 to July 2019 were enrolled in this study. All the procedures were performed under local anesthesia. There were 40 cases in the ICE group, including 23 cases with combined catheter ablation and LAAC in a single operation. There were 50 cases in the TEE group, including 28 cases with combined procedures. Another 12 patients underwent LAAC with both ICE and TEE imaging. All patients received pre-procedural TEE to assess LAA anatomy and to exclude LAA thrombus. Written informed consent was obtained from all the participants and the study was approved by ethical committee of the local institution.