Intracardiac Echocardiography to Guide Left Atrial Appendage Occlusion: An Update.

The left atrial appendage occlusion (LAAO) procedure is an important intervention for stroke prevention in patients with non-valvular atrial fibrillation who cannot tolerate anticoagulation. Accurate imaging is essential to guide and ensure optimal device deployment. Transesophageal echocardiography (TEE) has traditionally been the gold standard for procedural guidance, but intracardiac echocardiography (ICE) is emerging as an alternative owing to its unique advantages. This review examines the comparative effectiveness, procedural advantages, limitations, and clinical outcomes of ICE and TEE in LAAO closure, highlighting emerging trends and implications for future clinical practice.