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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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Intracardiac echocardiography for guidance of percutaneous left atrial appendix occlusion – a meta-analysis
Session:
Posters 1 - Écran 10 - Arritmologia
Speaker:
Joana Ribeiro
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.5 Atrial Fibrillation - Stroke Prevention
Session Type:
Posters
FP Number:
---
Authors:
Joana M. Ribeiro; Rogerio Teixeira; Luís Puga; João Lopes; José Pedro Sousa; Carolina Saleiro; Diana Decampos; Alexandrina Siserman; Marco Costa; Lino Gonçalves
Abstract
<p><strong>Background</strong>: Intracardiac echocardiography (ICE) use during percutaneous structural interventions has been growing. The most obvious advantage of ICE is that it obviates the need for general anaesthesia. Patients referred for percutaneous left atrial appendix occlusion (LAAO) often have multiple comorbidities and a high anaesthetic risk, and an ICE guided approach is particularly attractive in this setting.</p> <p><strong>Aims</strong>: To assess the efficacy and safety of an ICE versus transoesophageal (TOE) guidance for percutaneous LAAO.</p> <p><strong>Methods</strong>: We searched the MEDLINE for all articles comparing ICE and TOE for guidance of percutaneous LAAO. Our primary endpoint was procedural success and secondary endpoints included procedural complications, procedural time and fluoroscopy time. Data was aggregated at time using random-effects meta-analysis models</p> <p><strong>Results</strong>: Five studies were included in the analysis, providing a total of 1122 patients – 393 patients in the ICE group and 729 patients in the TOE group. Procedural success was numerically higher in the ICE group, although statistical significance was not reached (pooled OR 1,78; CI 0.94-3.40, <em>P</em>=0.08, <em>I<sup>2</sup></em>0%[C1] ). Likewise, periprocedural complications tended to be lower in the ICE group, although this difference was also not significant (pooled OR 0.58, IC 0.31-1.07, <em>P</em>=0.08, <em>I<sup>2</sup> 0%</em>) - figure 1, panel A and B, respectively. Procedural and fluoroscopy time were similar for both imaging strategies (mean difference -6.2 minutes, CI -18.8-6.4, <em>P</em>=0.33 for procedural time and mean difference 0.4 minutes, CI -2.5-3.3, <em>P</em>=0.77 for fluoroscopy time).</p> <p><strong>Conclusions</strong>: To the best of our knowledge, this is the first meta-analysis to report that an ICE based approach can provide a similar efficacy and safety, compared to a TOE strategy, for guidance of percutaneous LAAO.</p> <p> [C1]Deves colocar o I2</p>
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