title: Visualization of the left atrial appendage by phased-array intracardiac echocardiography from the pulmonary artery in patients with atrial fibrillation.
abstract: OBJECTIVE
  The left atrial appendage (LAA) represents the major source of cardiac thrombus formation in patients with atrial fibrillation (AF). Phased-array intracardiac echocardiography (ICE) has become available and frequently used during catheter ablation of AF. We attempted to study the feasibility of using ICE for the visualization and evaluation of the LAA from the pulmonary artery (PA) in patients with AF.
  
  
  RESULTS
  Eighty patients with AF undergoing catheter ablation (70 males, 57.5 ± 9.1 years) were included. Transoesophageal echocardiography was performed on the prior day before the catheter ablation, and ICE was performed just before the transseptal puncture during the catheter ablation. The ICE catheter was advanced up into the PA from the femoral vein, where the LAA was clearly and entirely visualized by manipulating the ICE catheter. We compared the degree of spontaneous echo contrast, and the correlation was obtained between the ICE and TEE (κ = 0.534, P < 0.001). Furthermore, the LAA flow velocity (LAA emptying and filling velocities) measured by ICE had a good correlation to that measured by TEE (R = 0.872, P < 0.01 and R = 0.753, P < 0.01, respectively). No patients developed any complications.
  
  
  CONCLUSIONS
  The utilization of ICE in the PA is feasible for the observation and evaluation of the LAA.
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Takahiko
authors: T
authors: Nishiyama
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Yoshinori
authors: Y
authors: Katsumata
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Kohei
authors: K
authors: Inagawa
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Takehiro
authors: T
authors: Kimura
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Nobuhiro
authors: N
authors: Nishiyama
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Kotaro
authors: K
authors: Fukumoto
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Yoko
authors: Y
authors: Tanimoto
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Yoshiyasu
authors: Y
authors: Aizawa
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Kojiro
authors: K
authors: Tanimoto
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan.
authors: Keiichi
authors: K
authors: Fukuda
authors: Department of Cardiology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo 160-8582, Japan seiji.takatsuki@gmail.com.
authors: Seiji
authors: S
authors: Takatsuki
mesh_terms: D020517:Atrial Appendage / Q000000981:diagnostic imaging*; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging*; D004452:Echocardiography / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Atrial fibrillation; Catheter ablation; Intracardiac echocardiography; Left atrial appendage