The Emerging Role of Intracardiac Echocardiography -- Into the ICE Age

Andrew R.J. Mitchell; Prasanna Puwanarajah; Jonathan Timperley; Harald Becher; Neil Wilson; Oliver J. Ormerod

Disclosures

Br J Cardiol. 2007;14(1):31-36. 

In This Article

Abstract and Introduction

Abstract

Intracardiac echocardiography (ICE) is an imaging technique that is becoming increasingly available as an alternative to transoesophageal echocardiography to guide percutaneous interventional procedures. The probe can be inserted under local anaesthesia and is principally used during closure of atrial septal abnormalities. The main advantages of ICE over transoesophageal echocardiography include the elimination of the need for general anaesthesia, clearer imaging, shorter procedure times and reduced radiation doses to the patient. Within this article we review some of the current applications of ICE and how to image from within the heart.

Introduction

Intracardiac echocardiography (ICE) is one of the latest developments in the ever expanding field of cardiac ultrasound and, within this review, we discuss some of the current applications of ICE and how to image from within the heart.

Transvenous echocardiography has been described for over 20 years.[1] The initial limitations of poor tissue penetration and difficult manipulation with mechanical intracardiac catheters have been overcome with the development of low-frequency transducers and multi-directional steerable devices. The AcuNav™ (Siemens Medical) ICE catheter is a medium calibre (8F or 10F), multi-frequency (5 to 10 MHz), 64-element, linear phased array, ultrasound catheter capable of pulsed and colour Doppler imaging (figure 1). The catheter provides a 90° sector scan, has tissue penetration of up to 10 cm and has four-way head articulation to allow multiple angle imaging. There is a steering lock to maintain angulation of the catheter. The devices are single-use only.

Figure 1.

AcuNav™ intracardiac echocardiography catheters.

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