Utility of Intracardiac Echocardiography to Guide Transseptal Catheterization for Different Electrophysiology Procedures

2021 ◽  
Author(s):  
Deep Chandh Raja ◽  
Prashanthan Sanders ◽  
Rajeev Kumar Pathak
Keyword(s):  
Intracardiac Echocardiography ◽  
Transseptal Catheterization

scholarly journals First-in-Human Use of a Novel 4D Intracardiac Echocardiography Catheter To Guide Interventional Electrophysiology Procedures

2021 ◽  
Author(s):  
Rachel Kaplan ◽  
Akhil Narang ◽  
Hawkins Gay ◽  
Xu Gao ◽  
Mohammed Gibreal ◽  
...  
Keyword(s):  
Real Time ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Intracardiac Echocardiography ◽  
Left Atrial Appendage Closure ◽  
High Quality ◽  
Interventional Electrophysiology ◽  
Transseptal Catheterization ◽  
2D And 3D

Introduction: Standard two-dimensional (2D), phased-array intracardiac echocardiography (ICE) is routinely used to guide interventional electrophysiology (EP) procedures. A novel four-dimensional (4D) ICE catheter (VeriSight Pro®, Philips, Andover, MA) can obtain 2D and three-dimensional (3D) volumetric images and cine-videos in real time (4D). The purpose of this study was to determine the early feasibility and safety of this 4D ICE catheter during EP procedures. Methods: The 4D ICE catheter was placed from the femoral vein in ten patients into various cardiac chambers to guide EP procedures requiring transseptal catheterization, including ablation for atrial fibrillation and left atrial appendage closure. 2D- and 3D- ICE images were acquired in real time by the electrophysiologist. A dedicated imaging expert performed digital steering to optimize and post-process 4D images. Results: Eight patients underwent pulmonary vein isolation (cryoballoon in 7 patients, pulsed field ablation in 1, additional radiofrequency left atrial ablation in 1). Two patients underwent left atrial appendage closure. High quality images of cardiac structures, transseptal catheterization equipment, guide sheaths, ablation tools, and closure devices were acquired with the ICE catheter tip positioned in the right atrium, left atrium, pulmonary vein, coronary sinus, right ventricle, and pulmonary artery. There were no complications. Conclusion: This is the first-in-human experience of a novel deflectable 4D ICE catheter used to guide EP procedures. 4D ICE imaging in safe and allows for acquisition of high-quality 2D and 3D images in real-time. Further use of 4D ICE will be needed to determine its added value for each EP procedure type.

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 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.

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