The Use of Intracardiac Echocardiography (ICE) to Guide LAA Closure

2016 ◽  
pp. 101-115
Author(s):  
Sergio Berti ◽  
Umberto Paradossi ◽  
Gennaro Santoro
Keyword(s):  
Intracardiac Echocardiography ◽  
Laa Closure

Radiofrequency Catheter Modification of Sinus Pacemaker Function Guided by Intracardiac Echocardiography

Circulation ◽  
1995 ◽  
Vol 92 (10) ◽  
pp. 3070-3081 ◽  
Author(s):  
Jonathan M. Kalman ◽  
Randall J. Lee ◽  
Westby G. Fisher ◽  
Michael C. Chin ◽  
Phillip Ursell ◽  
...  
Keyword(s):  
Intracardiac Echocardiography ◽  
Pacemaker Function

scholarly journals Catheter ablation of short-coupled variant of torsade de pointes

2021 ◽  
Author(s):  
Johannes Steinfurt ◽  
Babak Nazer ◽  
Martin Aguilar ◽  
Joshua Moss ◽  
Satoshi Higuchi ◽  
...  
Keyword(s):  
Catheter Ablation ◽  
Torsade De Pointes ◽  
Intracardiac Echocardiography ◽  
Long Term Results ◽  
Electrical Storm ◽  
3D Mapping ◽  
Free Wall ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy

Abstract Background The short-coupled variant of torsade de pointes (sc-TdP) is a malignant arrhythmia that frequently presents with ventricular fibrillation (VF) electrical storm. Verapamil is considered the first-line therapy of sc-TdP while catheter ablation is not widely adopted. The aim of this study was to determine the origin of sc-TdP and to assess the outcome of catheter ablation using 3D-mapping. Methods and results We retrospectively analyzed five patients with sc-TdP who underwent 3D-mapping and ablation of sc-TdP at five different institutions. Four patients initially presented with sudden cardiac arrest, one patient experienced recurrent syncope as the first manifestation. All patients demonstrated a monomorphic premature ventricular contraction (PVC) with late transition left bundle branch block pattern, superior axis, and a coupling interval of less than 300 ms. triggering recurrent TdP and VF. In four patients, the culprit PVC was mapped to the free wall insertion of the moderator band (MB) with a preceding Purkinje potential in two patients. Catheter ablation using 3D-mapping and intracardiac echocardiography eliminated sc-TdP in all patients, with no recurrence at mean 2.7 years (range 6 months to 8 years) of follow-up. Conclusion 3D-mapping and intracardiac echocardiography demonstrate that sc-TdP predominantly originates from the MB free wall insertion and its Purkinje network. Catheter ablation of the culprit PVC at the MB free wall junction leads to excellent short- and long-term results and should be considered as first-line therapy in recurrent sc-TdP or electrical storm. Graphic abstract

scholarly journals Transcatheter Closure of PFO and ASD: Multimodality Imaging for Patient Selection and Perioperative Guidance

2021 ◽  
Vol 8 (7) ◽  
pp. 78
Author(s):  
Gabriele Egidy Assenza ◽  
Luca Spinardi ◽  
Elisabetta Mariucci ◽  
Anna Balducci ◽  
Luca Ragni ◽  
...  
Keyword(s):  
Patient Selection ◽  
Transcatheter Closure ◽  
Multimodality Imaging ◽  
Deep Understanding ◽  
Volume Overload ◽  
Arterial Embolization ◽  
Ventricular Volume ◽  
Intracardiac Echocardiography ◽  
Technical Details ◽  
Asd Closure

Transcatheter closure of patent foramen ovale (PFO) and secundum type atrial septal defect (ASD) are common transcatheter procedures. Although they share many technical details, these procedures are targeting two different clinical indications. PFO closure is usually considered to prevent recurrent embolic stroke/systemic arterial embolization, ASD closure is indicated in patients with large left-to-right shunt, right ventricular volume overload, and normal pulmonary vascular resistance. Multimodality imaging plays a key role for patient selection, periprocedural monitoring, and follow-up surveillance. In addition to routine cardiovascular examinations, advanced neuroimaging studies, transcranial-Doppler, and interventional transesophageal echocardiography/intracardiac echocardiography are now increasingly used to deliver safely and effectively such procedures. Long-standing collaboration between interventional cardiologist, neuroradiologist, and cardiac imager is essential and it requires a standardized approach to image acquisition and interpretation. Periprocedural monitoring should be performed by experienced operators with deep understanding of technical details of transcatheter intervention. This review summarizes the specific role of different imaging modalities for PFO and ASD transcatheter closure, describing important pre-procedural and intra-procedural details and providing examples of procedural pitfall and complications.

Intracardiac echocardiography during interventional catheterization for congenital heart defects

2002 ◽  
Vol 39 ◽  
pp. 412
Author(s):  
John F. Rhodes ◽  
Tamar J. Preminger ◽  
Cesar I. Mesia ◽  
Geoffrey K. Lane ◽  
Lourdes R. Prieto ◽  
...  
Keyword(s):  
Congenital Heart Defects ◽  
Congenital Heart ◽  
Heart Defects ◽  
Intracardiac Echocardiography ◽  
Interventional Catheterization

scholarly journals Publisher Correction: Implantation of Impella CP left ventricular assist device under the guidance of three-dimensional intracardiac echocardiography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Konstantin Yastrebov ◽  
Laurencie Brunel ◽  
Hugh S. Paterson ◽  
Zoe A. Williams ◽  
Innes K. Wise ◽  
...  
Keyword(s):  
Left Ventricular Assist Device ◽  
Ventricular Assist Device ◽  
Three Dimensional ◽  
Intracardiac Echocardiography ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

scholarly journals Safety and effects of volume loading during transesophageal echocardiography in the pre-procedural work-up for left atrial appendage closure

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Afonso B. Freitas-Ferraz ◽  
Mathieu Bernier ◽  
Kim O’Connor ◽  
Jonathan Beaudoin ◽  
Jean Champagne ◽  
...  
Keyword(s):  
Transesophageal Echocardiography ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Atrial Appendage ◽  
Maximum Diameter ◽  
Volume Loading ◽  
Fluid Bolus ◽  
Work Up ◽  
Device Size ◽  
Laa Closure

Abstract Background In patients undergoing left atrial appendage (LAA) closure, an accurate sizing of the LAA is key to optimize device sizing, procedural success and reduce complications. Previous studies have shown that intraprocedural volume loading increases LAA dimensions and improves device sizing. However, the safety and effects on LAA and device sizing of administering a fluid bolus during pre-procedural transesophageal echocardiography (TEE) are unknown. The aim of this study was to determine the safety and impact on LAA dimensions and device sizing of an intravenous (IV) fluid bolus administered during TEE in the setting of the pre-procedural work-up for LAA closure. Methods The study included a total of 72 patients who underwent TEE to assess suitability for LAAC and received a 500 ml IV bolus of normal saline. The LAA landing zone (LZ) and depth were measured by TEE before and after volume loading, and these measurements were used to predict the device size implanted during a subsequent percutaneous LAAC procedure. Results There were no complications associated with volume loading. The baseline mean LZ was 19.6 ± 3.6 mm at 90o, and 20.2 ± 4.1 mm at 135o. Following fluid bolus, the maximum diameter increased 1.5 ± 1.0 mm at 90o (p<0.001), and 1.3 ± 1.0 mm at 135o (p<0.001). The baseline mean depth of the LAA was 26.5 ± 5.5 mm at 90o, and 23.9 ± 5.8 mm at 135o. After fluid bolus, the mean depth increased by 1.5 ± 1.8 mm (p<0.001) and 1.6 ± 2.0 (p<0.001), at 90o and 135o, respectively. Sizing based on post-bolus measurements of the LZ significantly improved the agreement with the final device size selection during the procedure in 71.0% of cases (vs. 42.0% with pre-bolus measurements). Conclusions Volume loading during ambulatory TEE as part of the pre-procedural work-up of LAAC is safe and significantly increases LAA dimensions. This strategy may become the new standard, particularly in centers performing LAAC with no TEE guidance, as it improves LAA sizing and more accurately predicts the final device size.

scholarly journals Into a Fluoroless Future: an Appraisal of Fluoroscopy-Free Techniques in Clinical Cardiac Electrophysiology

2021 ◽  
Vol 23 (4) ◽  
Author(s):  
Christopher S. Purtell ◽  
Ryan T. Kipp ◽  
Lee L. Eckhardt
Keyword(s):  
Cardiac Electrophysiology ◽  
Imaging Technique ◽  
Early Experience ◽  
Intracardiac Echocardiography ◽  
Electroanatomic Mapping ◽  
Supporting Evidence ◽  
Device Implantation ◽  
Mri Guidance ◽  
Fluoroscopic Imaging ◽  
Mapping Systems

Abstract Purpose of Review There are risks to both patients and electrophysiology providers from radiation exposure from fluoroscopic imaging, and there is increased interest in fluoroscopic reduction. We review the imaging tools, their applications, and current uses to eliminate fluoroscopy. Recent Findings Multiple recent studies provide supporting evidence for the transition to fluoroscopy-free techniques for both ablations and device implantation. The most frequently used alternative imaging approaches include intracardiac echocardiography, cardiac MRI guidance, and 3D electroanatomic mapping systems. Electroanatomic mapping and intracardiac echocardiography originally used to augment fluoroscopy imaging are now replacing the older imaging technique. The data supports that the future of electrophysiology can be fluoroscopy-free or very low fluoroscopy for the vast majority of cases. Summary As provider and institution experience grows with these techniques, many EP labs may choose to completely forego the use of fluoroscopy. Trainees will benefit from early experience with these techniques.

Stepwise approach for visualization and reconstruction of pulmonary valve with intracardiac echocardiography

2021 ◽  
Author(s):  
Francesco De Sensi ◽  
Luigi Addonisio ◽  
Gennaro Miracapillo ◽  
Marco Breschi ◽  
Alberto Cresti ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Intracardiac Echocardiography ◽  
Stepwise Approach
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