How to use intracardiac echocardiography for atrial fibrillation ablation procedures

Published:November 10, 2006DOI:
      Intracardiac echocardiography (ICE) has been an important tool in the development of advanced catheter ablation procedures. ICE technology now allows complete echocardiographic interrogation of all four heart chambers from the right atrium. A list of the uses for ICE in ablation procedures is given in Table 1.
      Table 1Uses for intracardiac echocardiography in ablation procedures
      • Identification of atrial anatomy
      • Facilitation of transseptal puncture
      • Catheter navigation and positioning
      • Visualization of pulmonary venous anatomy
      • Identification of procedural complications
        • Pulmonary vein stenosis
        • Pericardial effusion
        • Microbubble formation (tissue overheating)
        • Thrombus formation on sheath/catheter
      • Assessment of electrode–tissue contact
      • Visualization of esophagus–atrial continuity
      • Titration of radiofrequency energy
      • Visualization of radiofrequency lesion generation
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Heart Rhythm
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mangrum J.M.
        • Mounsey J.P.
        • Kok L.C.
        • DiMarco J.P.
        • Haines D.E.
        Intracardiac echocardiography-guided, anatomically based radiofrequency ablation of focal atrial fibrillation originating from pulmonary veins.
        J Am Coll Cardiol. 2002; 39: 1964-1972
        • Ren J.-F.
        • Marchlinski F.E.
        • Callans D.J.
        • Herrmann H.C.
        Clinical use of AcuNav diagnostic ultrasound catheter during left heart radiofrequency ablation and transcatheter closure procedures.
        J Am Soc Echocardiogr. 2002; 15: 1301-1308
        • Marrouche N.F.
        • Martin D.O.
        • Wazni O.
        • Gillinov A.M.
        • Klein A.
        • Bhargava M.
        • Saad E.
        • Bash D.
        • Yamada H.
        • Jaber W.
        • Schweikert R.
        • Tchou P.
        • Abdul-Karim A.
        • Saliba W.
        • Natale A.
        Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: impact on outcome and complications.
        Circulation. 2003; 107: 2710-2716
        • Schwartzman D.
        • Nosbisch J.
        • Housel D.
        Echocardiographically guided left atrial ablation: characterization of a new technique.
        Heart Rhythm. 2006; 3: 930-938
        • Ren J.-F.
        • Marchlinski F.E.
        • Callans D.J.
        • Gerstenfeld E.P.
        • Dixit S.
        • Lin D.
        • Nayak H.M.
        • Hsia H.H.
        Increased intensity of anticoagulation may reduce risk of thrombus during atrial fibrillation ablation procedures in patients with spontaneous echo contrast.
        J Cardiovasc Electrophysiol. 2005; 16: 474-477