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Hu T, Chen T, Maduray K, Han W, Zhong J. Intracardiac Echocardiography: An Invaluable Tool in Electrophysiological Interventions for Atrial Fibrillation and Supraventricular Tachycardia. Rev Cardiovasc Med 2024; 25:191. [PMID: 39076314 PMCID: PMC11270097 DOI: 10.31083/j.rcm2506191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 07/31/2024] Open
Abstract
Researchers have investigated ways to develop optimal imaging techniques to increase the safety and effectiveness of electrophysiological (EP) procedures. Intracardiac echocardiography (ICE) is an advanced imaging tool that can directly visualize cardiac anatomical structures in high resolution, assess tissue heterogeneity and arrhythmogenic substrates, locate intracardiac catheters, monitor catheter-tissue contact and ablation injury in real-time, excluding intracardiac thrombi, and quickly detect procedural complications. Additionally, real-time imaging via ICE can be integrated with a three-dimensional (3D) electroanatomical mapping (EAM) system to reconstruct cardiac anatomy. This technique also promotes the development of zero-radiation EP procedures. Many EP studies and procedures have implemented ICE because it has several advantages over fluoroscopy and transesophageal echocardiography (TEE). ICE-guided EP procedures can be performed under conscious sedation; esophageal intubation and additional anesthesiologists are not required. Atrial fibrillation (AF) and supraventricular tachycardias (SVT) are the most common tachyarrhythmias in clinical settings. A comprehensive understanding of critical anatomical structures, such as the atrial septum, fossa ovalis (FO), and great heart vessels, is needed for the successful catheter ablation of these arrhythmias.
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Affiliation(s)
- Tong Hu
- National Key Laboratory for Innovation and Transformation of Luobing
Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research,
Chinese Ministry of Education, Chinese National Health Commission and Chinese
Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong
University, 250012 Jinan, Shandong, China
| | - Tongshuai Chen
- National Key Laboratory for Innovation and Transformation of Luobing
Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research,
Chinese Ministry of Education, Chinese National Health Commission and Chinese
Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong
University, 250012 Jinan, Shandong, China
| | - Kellina Maduray
- National Key Laboratory for Innovation and Transformation of Luobing
Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research,
Chinese Ministry of Education, Chinese National Health Commission and Chinese
Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong
University, 250012 Jinan, Shandong, China
| | - Wenqiang Han
- National Key Laboratory for Innovation and Transformation of Luobing
Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research,
Chinese Ministry of Education, Chinese National Health Commission and Chinese
Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong
University, 250012 Jinan, Shandong, China
| | - Jingquan Zhong
- National Key Laboratory for Innovation and Transformation of Luobing
Theory; The Key Laboratory of Cardiovascular Remodeling and Function Research,
Chinese Ministry of Education, Chinese National Health Commission and Chinese
Academy of Medical Sciences; Department of Cardiology, Qilu Hospital of Shandong
University, 250012 Jinan, Shandong, China
- Department of Cardiology, Qilu Hospital (Qingdao), Cheeloo College of
Medicine, Shandong University, 266035 Qingdao, Shandong, China
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Garg J, Kewcharoen J, Contractor T, Mandapati R, Bhardwaj R. Intracardiac Echocardiogram from Persistent Left Superior Vena Cava. Am J Cardiol 2024; 210:225-228. [PMID: 38682714 DOI: 10.1016/j.amjcard.2023.10.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 10/23/2023] [Indexed: 05/01/2024]
Affiliation(s)
- Jalaj Garg
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California.
| | - Jakrin Kewcharoen
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California
| | - Tahmeed Contractor
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California
| | - Ravi Mandapati
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California
| | - Rahul Bhardwaj
- Division of Cardiology, Cardiac Arrhythmia Service, Loma Linda University Health, Loma Linda, California
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Garg J, Kewcharoen J, Bhardwaj R, Contractor T, Jain S, Mandapati R. Intracardiac echocardiography from coronary sinus. J Cardiovasc Electrophysiol 2022; 33:2382-2388. [PMID: 36153661 PMCID: PMC9828028 DOI: 10.1111/jce.15687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/28/2022] [Accepted: 09/17/2022] [Indexed: 01/12/2023]
Abstract
Intracardiac echocardiography (ICE) has become an essential tool and is an integral part of percutaneous interventional and electrophysiology (EP) procedures. Intracardiac echocardiography offers real-time, high-quality, near-field evaluation of cardiac anatomy. Standard ICE imaging includes placing the catheter in the right atrium (RA), right ventricle (RV), or left atrium (LA, via the transeptal approach). Coronary sinus echocardiography (CSE) is another alternative, where the ICE catheter is positioned in the coronary sinus (CS). This approach offers better catheter stability and allows operators to visualize cardiac structure with particularly excellent views of the LA, LAA, left ventricle (LV), and mitral annulus. Additionally, CSE is an attractive alternative in cases with unfavorable interatrial septum or fossa ovalis anatomical features that could lead to difficulty advancing ICE catheter in left atrium. In this article focusing on CSE, we provide illustration-based guidance to help operators identify critical cardiac structures from CSE.
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Affiliation(s)
- Jalaj Garg
- Division of Cardiology, Cardiac Arrhythmia ServiceLoma Linda University HealthLoma LindaCaliforniaUSA
| | - Jakrin Kewcharoen
- Division of Cardiology, Cardiac Arrhythmia ServiceLoma Linda University HealthLoma LindaCaliforniaUSA
| | - Rahul Bhardwaj
- Division of Cardiology, Cardiac Arrhythmia ServiceLoma Linda University HealthLoma LindaCaliforniaUSA
| | - Tahmeed Contractor
- Division of Cardiology, Cardiac Arrhythmia ServiceLoma Linda University HealthLoma LindaCaliforniaUSA
| | - Sarika Jain
- Division of Cardiothoracic SurgeryLoma Linda University HealthLoma LindaCaliforniaUSA
| | - Ravi Mandapati
- Division of Cardiology, Cardiac Arrhythmia ServiceLoma Linda University HealthLoma LindaCaliforniaUSA
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