4.5 Study limitations
This was a small, non-randomized feasibility study. Although the study
results could not be fully extrapolated to other LAA occluding devices,
but were more representative in pacifier LAAC devices. Three-dimensional
(3D) TEE with multi-planar reconstruction function may help to enhance
the accuracy of LAA and device assessment but the precision of 3D images
still based on the quality of 2D images15,16. The
development of 3D-ICE is currently underway which may provide new
insights in guiding LAAC in the future17. Our study
only used a single type of ICE catheter (Sound-Star, Biosense Webster,
Diamond Bar, CA) which was soft and flexible allowing safe manipulation
in LA under Carto3 mapping system guidance. Lastly, ICE catheter was
maneuvered by experienced electrophysiologists in current study.