Intracardiac echocardiography during radiofrequency catheter ablation of cardiac arrhythmias in humans

Chu, Edward; Kalman, Jonathan M.; Kwasman, Michael; Jue, John; Fitzgerald, Peter J.; Epstein, Laurence M.; Schiller, Nelson B.; Yock, Paul G.; Lesh, Michael D.

doi:10.1016/0735-1097(94)90119-8

Cited by 143 publications

(62 citation statements)

References 22 publications

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“…Several studies have demonstrated the utility of intracardiac ultrasound for guiding cardiac ablation therapy [11][12][13] and visualizing thermal lesions in vitro. 10,14 A recent study by Epstein and colleagues 15 compared intracardiac ultrasound to fluoroscopy guidance for creating linear right atrial lesions in a canine model and showed that intracardiac ultrasound significantly improved targeting, energy delivery, and lesion formation.…”

Section: Comparison With Other Imaging Modalitiesmentioning

confidence: 99%

Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

et al. 2000

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Background-The purpose of this study was to describe a system and method for creating, visualizing, and monitoring cardiac radiofrequency ablation (RFA) therapy during magnetic resonance imaging (MRI). Methods and Results-RFA was performed in the right ventricular apex of 6 healthy mongrel dogs with a custom 7F nonmagnetic ablation catheter (4-mm electrode) in a newly developed real-time interactive cardiac MRI system. Catheters were positioned to intracardiac targets by use of an MRI fluoroscopy sequence, and ablated tissue was imaged with T2-weighted fast spin-echo and contrast-enhanced T1-weighted gradient-echo sequences. Lesion size by MRI was determined and compared with measurements at gross and histopathological examination. Ablated areas of myocardium appeared as hyperintense regions directly adjacent to the catheter tip and could be detected 2 minutes after RF delivery. Lesions reached maximum size Ϸ5 minutes after ablation, whereas lesion signal intensity increased linearly with time but then reached a plateau at 12.

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Section: Comparison With Other Imaging Modalitiesmentioning

confidence: 99%

Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

et al. 2000

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“…Its effectiveness in visualizing LA thrombi during ablative procedures has been demonstrated in observational studies. [7][8][9][10][11][12] ICE has been used to assist in diagnosing the frequency of dense SEC, which could identify an increased risk of LA thrombus. 12 However, a comparative study of these the TEE and ICE imaging techniques is currently unavailable.…”

Section: Editorial See P 564 Clinical Perspective On P 577mentioning

confidence: 99%

A Prospective Comparison of Cardiac Imaging Using Intracardiac Echocardiography With Transesophageal Echocardiography in Patients With Atrial Fibrillation

Saksena

Sra

Jordaens

et al. 2010

Circ: Arrhythmia and Electrophysiology

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Background-The Intracardiac Echocardiography Guided Cardioversion Helps Interventional Procedures study evaluatedthe concordance of intracardiac echocardiography (ICE) with transesophageal echocardiography (TEE) in patients with atrial fibrillation (AF). Methods and Results-Patients with AF undergoing right heart catheterization underwent left atrium (LA) and interatrial septal (IAS) imaging by TEE and ICE. A blinded comparison of the 2 modalities was performed at a core laboratory. Ninety-five patients aged 58Ϯ12 years completed the study. The LA was profiled in all patients with both techniques, and concordance for image quality was 96%. LA appendage (LAA) imaging was achieved in 85% with ICE and 96% with TEE. There was no difference in the presence of spontaneous echo contrast between ICE and TEE during LA imaging, but there was a trend toward a greater incidence in the LAA with TEE (Pϭ0.109). Intracardiac thrombus was uncommonly seen (TEE, 6.9%; ICE, 5.2%). The concordance for the presence or absence of thrombus was 97% in the LA and 92% in the LAA, but the latter was detected more frequently with TEE. IAS imaging was achieved in 91% with ICE and in 97% with TEE (Pϭ0.177). Concordance for patent foramen ovale and atrial septal aneurysms was 100% and 96%, respectively. A negative ICE examination was associated with absence of dense echo contrast or thrombus on TEE in 86%. Conclusions-This

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“…It is possible that the anatomic approach would have been more effective under the guidance of intracardiac echocardiography 22 or electroanatomic mapping. 2 3 ,2 4 …”

Section: Study Limitationsmentioning

confidence: 99%

Randomized Comparison of Anatomic and Electrogram Mapping Approaches to Ablation of Typical Atrial Flutter

Tada

Oral

Özaydın

et al. 2002

Cardiovasc electrophysiol

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Isthmus Ablation. Introduction: The cavotricuspid isthmus can be ablated using an anatomic approach or an electrogram mapping approach in which sites at which there is a gap in the line of block are targeted. The aim of this study was to compare the anatomic and electrogram mapping approaches for creating a line of block in the cavotricuspid isthmus after an initial, unsuccessful anatomically directed ablation line. Methods and Results:The subjects of this study were 63 patients with isthmus-dependent atrial utter in whom a single series of contiguous applications of radiofrequency energy guided by uoroscopy in the cavotricuspid isthmus did not result in complete block. The patients were randomly assigned to additional ablation on an anatomic basis (n 5 31) or guided by single potentials or narrowly split double potentials during coronary sinus pacing (n 5 32). After every 15 applications of radiofrequency energy, the alternate approach was used until complete block was achieved. Before cross-over, complete block was achieved in 6 patients (19%) with the anatomic approach compared with 19 patients (59%) with the electrogram mapping approach (P < 0.005). The electrogram mapping approach also was more effective than the anatomic approach in achieving complete isthmus block after the rst cross-over (72% vs 23%, P < 0.005) and after the second cross-over (80% vs 42%, P < 0.05). Conclusion:When there is incomplete block after an initial series of applications of radiofrequency energy in the cavotricuspid isthmus, complete block is achieved more ef ciently with an electrogram mapping approach than with an anatomic

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Intracardiac echocardiography during radiofrequency catheter ablation of cardiac arrhythmias in humans

Cited by 143 publications

References 22 publications

Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

A Prospective Comparison of Cardiac Imaging Using Intracardiac Echocardiography With Transesophageal Echocardiography in Patients With Atrial Fibrillation

Randomized Comparison of Anatomic and Electrogram Mapping Approaches to Ablation of Typical Atrial Flutter

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