title: Intracardiac echocardiography in electrophysiology.
abstract: Intracardiac echocardiography (ICE) is a recent, invaluable tool which can provide real-time anatomical guidance in electrophysiological procedures. By inserting intravenously an ultrasound probe and advancing it into the heart, various different views can be obtained which allow to better visualize patient anatomy, to guide the placement of electrophysiological catheters, and to detect immediately procedural complications as they occur. In atrial fibrillation ablation, ICE proves particularly useful to achieve a safer trans-septal puncture (especially in the presence of anatomical anomalies of the interatrial septum) and to help to monitor the visualization of the mapping catheters (circular, high density), or the monitoring of the balloons catheter (Cryo, Laser) position. In ventricular tachycardia ablation, on the other hand, ICE allows for continuous correlation between electrophysiological and structural findings (such as wall motion anomalies or changes in echodensity), and helps to ensure correct catheter contact and to position it, particularly around delicate structures such as the aortic cusps. In any procedure, ICE is also useful to immediately detect procedural complications, such as thrombus formation along catheters, or pericardial effusion. Thanks to its real-time morphological information, ICE provides an ideal complement to simple fluoroscopy or to more complex electroanatomic mapping techniques and is set to gain a wider role in a broad range of electrophysiological procedures.
authors.affiliation: Cardiac Arrhythmia Research Center, Centro Cardiologico Monzino, Department of Cardiovascular Research, University of Milan, Milan, Italy. antonio.dellorusso@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Dello Russo
authors.forename: M
authors.initials: M
authors.lastname: Casella
authors.forename: G
authors.initials: G
authors.lastname: Pelargonio
authors.forename: F
authors.initials: F
authors.lastname: Bonelli
authors.forename: P
authors.initials: P
authors.lastname: Santangeli
authors.forename: G
authors.initials: G
authors.lastname: Fassini
authors.forename: S
authors.initials: S
authors.lastname: Riva
authors.forename: C
authors.initials: C
authors.lastname: Carbucicchio
authors.forename: F
authors.initials: F
authors.lastname: Giraldi
authors.forename: P
authors.initials: P
authors.lastname: De Iuliis
authors.forename: S
authors.initials: S
authors.lastname: Bartoletti
authors.forename: F
authors.initials: F
authors.lastname: Pintus
authors.forename: L
authors.initials: L
authors.lastname: Di Biase
authors.forename: M
authors.initials: M
authors.lastname: Pepi
authors.forename: A
authors.initials: A
authors.lastname: Natale
authors.forename: C
authors.initials: C
authors.lastname: Fiorentini
authors.forename: C
authors.initials: C
authors.lastname: Tondo
mesh_terms: D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D057791:Cardiac Imaging Techniques; D017115:Catheter Ablation; D015150:Echocardiography, Doppler / Q000379:methods; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans