Abstract
Purpose of Review
The advanced use of intracardiac echocardiography (ICE) is both a significant leap forward and an underutilized and unrealized innovation for electrophysiological (EP) procedures [1]. ICE can inform operators of complex anatomic heterogeneity as well as close anatomic relationships beyond fluoroscopy and even electroanatomic mapping. We will review the myriad advantages of advanced ICE application to EP ablation procedures.
Recent Findings
While 3D mapping has significantly advanced diagnosis and treatment efficiency for ablation procedures quite rapidly, widespread adoption of advanced ICE techniques beyond a supplemental technology has not been as swift. The advanced application of ICE has the ability to vastly improve the safety of EP procedures while reducing or eliminating required fluoroscopic guidance in many aspects [2].
Summary
The advanced application of ICE offers many opportunities to improve procedural efficacy and safety. Further research should focus on quantifying these benefits and understanding how best to disseminate these techniques for broader electrophysiological practice.
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References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Chu E, Fitzpatrick AP, Chin MC, Sudhir K, Yock PG, Lesh MD. Radiofrequency catheter ablation guided by intracardiac echocardiography. Circulation. 1994;89:1301–5.
Goya M, Frame D, Gache L, et al. The use of intracardiac echocardiography catheters in endocardial ablation of cardiac arrhythmia: meta-analysis of efficiency, effectiveness, and safety outcomes. J Cardiovasc Electrophysiol. 2020;31:664–73.
Christopoulos G, Siontis KC, Kucuk U, Asirvatham SJ. Cavotricuspid isthmus ablation for atrial flutter: anatomic challenges and troubleshooting. HeartRhythm Case Reports. 2020;6:115–20.
• Benhayon D, Nof E, Chik WW, Marchlinski F. Catheter ablation in the right ventricular outflow tract associated with occlusion of left anterior descending coronary artery. J Cardiovasc Electrophysiol 2017;28:347–350. This article describes the critical anatomic relationship between the RVOT and LAD coronary artery.
Enriquez A, Malavassi F, Saenz LC, et al. How to map and ablate left ventricular summit arrhythmias. Heart Rhythm. 2017;14:141–8.
Kuck KH, Brugada J, Fürnkranz A, et al. Cryoballoon or radiofrequency ablation for paroxysmal atrial fibrillation. N Engl J Med. 2016;374:2235–45.
Enriquez A, Saenz LC, Rosso R, et al. Use of intracardiac echocardiography in interventional cardiology. Circulation. 2018;137:2278–94.
• Ren JF, Marchlinski Francis E, Callans DJ. Left atrial thrombus associated with ablation for atrial fibrillation: identification with intracardiac echocardiography. J Am College of Cardiol 2004;43:1861–1867. This article describes the use of ICE to exclude LAA thrombus prior to atrial fibrillation ablation.
Goldstein JA, Balter S, Cowley M, Hodgson J, Klein LW. Occupational hazards of interventional cardiologists: prevalence of orthopedic health problems in contemporary practice. Catheter Cardiovasc Interv. 2004;63:407–11.
• Ferguson JD, Helms A, Mangrum JM, et al. Catheter ablation of atrial fibrillation without fluoroscopy using intracardiac echocardiography and electroanatomic mapping. Circulation Arrhyth Electrophysiol 2009;2:611–619. This article describes the use of ICE to obviate the need for fluoroscopy in the setting of atrial fibrillation ablation.
Herman D, Osmancik P, Zdarska J, Prochazkova R. Routine use of intracardiac echocardiography for atrial flutter ablation is associated with reduced fluoroscopy time, but not with a reduction of radiofrequency energy delivery time. J Atr Fibrillation. 2017;10:1553–1553.
Issa ZF, Miller JM, Zipes DP. Chapter 23 - Adenosine-sensitive (outflow tract) ventricular tachycardia. In: Issa ZF, Miller JM, Zipes DP, editors. Clinical arrhythmology and electrophysiology: a companion to Braunwald’s heart disease. 2nd ed. Philadelphia: W.B. Saunders; 2012;562–86.
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Daniel Alyesh, MD Consultant for Biosense Webster and Abbott. William Choe, MD Consultant for Abbott. Hany Demo, MD Consultant for Abbott. Speaker for Medtronic and Bayliss. Mansour Razminia, MD Consultant for Abbott and Bayliss. Sri Sundaram, MD Consultant for Abbott and Medtronic.
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This article is part of the Topical Collection on Invasive Electrophysiology and Pacing
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Alyesh, D., Choe, W., Demo, H. et al. The Advanced Application of Intracardiac Echocardiography for Cardiac Electrophysiology Ablation Procedures. Curr Cardiol Rep 24, 505–511 (2022). https://doi.org/10.1007/s11886-022-01672-x
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DOI: https://doi.org/10.1007/s11886-022-01672-x