Intracardiac echocardiography (ICE) has undergone a profound transformation in its role within left atrial appendage (LAA) closure – evolving from an experimental imaging adjunct to a clinically validated and increasingly adopted guidance strategy.
 
In this on-demand educational discussion, Prof Jens Erik Nielsen-Kudsk (Aarhus University Hospital, DK) and Dr Sergio Berti (Fondazione Toscana G. Monasterio, IT) reflect on the key clinical, procedural and technological milestones that have driven this evolution. Drawing on real-world experience, they explore the tipping points that accelerated ICE adoption, including improvements in image quality, procedural workflow, patient tolerability and growing operator confidence.
 
The discussion highlights how ICE has enabled new procedural paradigms – reducing reliance on transoesophageal echocardiography (TEE) and general anaesthesia – while maintaining procedural safety and imaging precision. This session provides valuable perspective for interventional and imaging teams seeking to understand how ICE is reshaping contemporary LAA closure programs and expanding access to care.