Utility of intracardiac echocardiography (ICE) in electrophysiology: ICEing the CAKE (catheter ablation knowledge enhancement).
OBJECTIVE
Previous studies have demonstrated the utility of intracardiac echocardiography (ICE) during electrophysiologic procedures including radiofrequency catheter ablation. The purpose of this study was to analyze the initial learning experience with ICE during invasive electrophysiologic procedures.


METHODS
During a 1-month ICE trial, patients scheduled for radiofrequency catheter ablation underwent concurrent imaging using a 9 French, 9 MHz catheter in the right atrium proximal to important endocardial structures and diagnostic/ablation catheters. The procedure length, fluoroscopy and ICE times were systematically recorded during each procedure. In addition, the images were analyzed and recorded and their utility was evaluated after each case. A case control analysis was also performed.


RESULTS
Seven patients underwent ICE (as part of an ICE trial period) during their electrophysiology study between July 21 and August 13, 1998. This study demonstrated the utility of ICE in identifying radiofrequency catheter tip stability and intracardiac and endocardial structures, including the crista terminalis, coronary sinus, and foramen ovale.


CONCLUSIONS
ICE contributes to the electrophysiology arsenal for both diagnostic and therapeutic procedures. In particular, this technique demonstrated a decrease in fluoroscopy time as compared to a case control population. This technique limits radiation to the patient and operator. In addition, endocardial structures, which may be pivotal in diagnosing and treating cardiac arrhythmias, were easily identified. Radiofrequency catheter stability can also be assessed with this technique.
Cohen
T J
TJ
Department of Medicine, Winthrop University Hospital, 259 First Street, Mineola, NY 11501, USA.
Ibrahim
B
B
Lazar
J
J
Rosen
J
J
Klein
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000601:surgery*; D016022:Case-Control Studies; D017115:Catheter Ablation; D004452:Echocardiography / Q000379:methods*; D004568:Electrodiagnosis; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged