Initial experience of using intracardiac echocardiography (ICE) for guiding balloon mitral valvuloplasty (BMV)

Ahmari, Saeed Al; Amro, Ahmed; Otabi, Mohammed Al; Abdullah, Moheeb; Kasab, Saad Al; Amri, Husien Al

doi:10.1016/j.jsha.2011.08.002

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…All analyses were performed using SAS statistical software package, version 9.4. 13 ) could help managing complications. Visualization of diaphragmatic motion during right phrenic nerve pacing might be used in addition to palpation aiming at early detection of phrenic nerve injury.…”

Section: Discussionmentioning

confidence: 99%

“…Detection of pulmonary vein variants and measuring of PV ostial diameters may lead to a more individualized ablation approach. Fast detection method for pericardial effusion and cardiac tamponade (ICE image showing pericardial effusion from Ahmari et al 13 ) could help managing complications. Visualization of diaphragmatic motion during right phrenic nerve pacing might be used in addition to palpation aiming at early detection of phrenic nerve injury.…”

Section: Introductionmentioning

confidence: 99%

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Impact of intracardiac echocardiography usage on the safety of cryoballoon atrial fibrillation ablation: Subanalysis of the prospective FREEZE cluster cohort study

Pongratz,

Kuniss,

et al. 2023

Cardiovasc electrophysiol

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IntroductionCryoballoon ablation (CBA) aiming at pulmonary vein isolation (PVI) became a standardized atrial fibrillation (AF) ablation procedure. Life‐threatening complications like cardiac tamponade exist. Intracardiac echocardiography (ICE) usage is associated with superior safety in radiofrequency ablation. It is unclear if ICE has an impact on safety of CBA.MethodsThe FREEZE Cohort (NCT01360008) subanalysis included patients undergoing “PVI only” CBA. Patients with intraprocedural transesophageal echocardiography were excluded. Group A comprises conventional, group B ICE‐guided CBA. Periprocedural results were compared.ResultsFrom 2011 to 2016, a total of 4189 patients were enrolled, and 1906 (45.5%) were included in this subanalysis, split up in two groups (A: 1066 [55.9%], B: 840 [44.1%]). Group A was younger (60.6 ± 10.8 vs. 62.4 ± 10.5 years, p < .001), with smaller left atria (41 vs. 43 mm, p < .001), and less persistent AF (23.1 vs. 38.1%, p < .001). Procedure, left atrial, and fluoroscopy times were shorter in group A as compared to group B. Dose area product was significantly higher in group A (2911 vs. 2072 cGyxcm2, p < .001).In‐hospital major adverse cerebrovascular and cardiac event rates including two deaths in group A were not different between groups (0.5% vs. 0.1%, p = .18). The rate of total procedural (10.4% vs. 5.1%, p < .001) and major complications (3.2% vs. 1.3%, p < .001) was significantly higher in group A. Cardiac tamponade occurred significantly more frequently in group A (8 [0.8%] vs. 1 [0.1%], p = .046). Independent predictors for major complications were female sex (odds ratio [OR] 2.03, p = .03) and non‐ICE usage (OR 2.38, p = .02). No differences were observed for persistent phrenic nerve palsy, nor for groin complications.ConclusionCBA was significantly safer and required less radiation if ICE was used, although the procedures were more complex. The risk of groin complications was not increased with ICE usage. Non‐ICE usage was the only modifiable independent predictor of major complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of intracardiac echocardiography usage on the safety of cryoballoon atrial fibrillation ablation: Subanalysis of the prospective FREEZE cluster cohort study

Pongratz,

Kuniss,

et al. 2023

Cardiovasc electrophysiol

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“…When compared to another more established real-time imaging modality, transesophageal echocardiography (TEE), ICE has improved patient tolerance by not requiring esophageal intubation, requires only local anesthesia with conscious sedation, does not require an additional sonographer operator for imaging, and does not interfere with fluoroscopic imaging [7]. Real-time ICE imaging has an expanding role in providing uninterrupted guidance for valve replacement interventions [8,9,10,11,12,13,14,15], left atrial appendage closure [16,17,18,19,20,21], septal defect closure [22,23,24], and catheter-based ablation for cardiac arrhythmia [25,26,27,28]. However, with the increased reliance on imaging to perform these complex procedures, there is a high cognitive demand on physicians, who now must perform both the interventional task and simultaneously acquire the guiding images.…”

Section: Introductionmentioning

confidence: 99%

Towards Automatic Manipulation of Intra-cardiac Echocardiography Catheter

Kim¹,

Collins²,

Li³

et al. 2020

Preprint

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Intra-cardiac Echocardiography (ICE) has been evolving as a real-time imaging modality of choice for guiding electrophiosology and structural heart interventions. ICE provides real-time imaging of anatomy, catheters, and complications such as pericardial effusion or thrombus formation. However, there now exists a high cognitive demand on physicians with the increased reliance on intraprocedural imaging. In response, we present a robotic manipulator for AcuNav ICE catheters to alleviate the physicians burden and support applied methods for more automated. Herein, we introduce two methods towards these goals: (1) a data-driven method to compensate kinematic model errors due to non-linear elasticity in catheter bending, providing more precise robotic control and (2) an automated image recovery process that allows physicians to bookmark images during intervention and automatically return with the push of a button. To validate our error compensation method, we demonstrate a complex rotation of the ultrasound imaging plane evaluated on benchtop. Automated view recovery is validated by repeated imaging of landmarks on benchtop and in vivo experiments with position-and image-based analysis. Results support that a robotic-assist system for more autonomous ICE can provide a safe and efficient tool, potentially reducing the execution time and allowing more complex procedures to become common place.

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Intracardiac Echocardiography for Structural Heart and Electrophysiological Interventions

2017

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Both transthoracic (TTE) and transesophageal echocardiography have limitations. ICE provides the advantage of imaging from within the heart, providing shorter image distances and higher resolution. ICE may be performed without sedation and avoids esophageal intubation as with transesophageal echocardiography (TEE). Limitations of ICE include the need for additional venous access with possibility of vascular complications, potentially higher costs, and a learning curve for new operators. Data supports the use of ICE in guiding device closure of interatrial shunts, transseptal puncture, and electrophysiologic procedures. This paper reviews the more recent reports that ICE may be used for primary guidance or as a supplement to TEE in patients undergoing left atrial appendage (LAA) closure, interatrial shunt closure, transaortic valve implantation (TAVI), percutaneous mitral valve repair (PMVR), paravalvular leak (PVL) closure, aortic interventions, transcatheter pulmonary valve replacement (tPVR), ventricular septal defect (VSD), and patent ductus arteriosus (PDA) closure. ICE imaging technology will continue to expand and help improve structural heart and electrophysiology interventions.

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Initial experience of using intracardiac echocardiography (ICE) for guiding balloon mitral valvuloplasty (BMV)

Abstract: ICE guidance of BMV is feasible, and useful in monitoring safe septal puncture, optimizing balloon positioning, and in detecting complications. The hemodynamic measurements obtained were comparable to those obtained by TTE, and cath.

Cited by 4 publications

References 10 publications

Impact of intracardiac echocardiography usage on the safety of cryoballoon atrial fibrillation ablation: Subanalysis of the prospective FREEZE cluster cohort study

Impact of intracardiac echocardiography usage on the safety of cryoballoon atrial fibrillation ablation: Subanalysis of the prospective FREEZE cluster cohort study

Towards Automatic Manipulation of Intra-cardiac Echocardiography Catheter

Intracardiac Echocardiography for Structural Heart and Electrophysiological Interventions

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