The purpose of this project was to examine the efficacy of using intracardiac echocardiography (ICE) guidance for Watchman device placement. Transesophageal echocardiology (TEE) with general anesthesia has been the standard for Watchman device placement, but ICE guided placement has become more prevalent.
The methods included a retrospective data analysis of 102 consecutive patients that underwent Watchman placement from May 2024 to October 2024 at a single hospital system. The results were compared for clinical, administrative, and financial endpoints. There were three groups of patients ICE with general anesthesia, ICE with conscious sedation and TEE with general anesthesia.
The significant clinical differences included the transseptal puncture location, ICE access approach, the involvement of interventionalists and imagers, and fluoroscopy time in minutes. From a financial perspective, total hospital charges were also significant. ICE with general anesthesia had the highest patient charges, followed by ICE with conscious sedation then TEE with general anesthesia with less charges.
In conclusion, this project’s findings indicate that Watchman placement with ICE is safe and effective for patients. The financial and administrative differences need further exploration. Difference in experience levels of interventionalists should be considered when examining results in future projects.