Percutaneous intrapericardial echocardiography during catheter ablation: a feasibility study

Area of Science:

• Cardiology
• Medical Imaging
• Electrophysiology

Background:

• Percutaneous pericardial access and epicardial mapping are established techniques for catheter ablation.
• Direct epicardial visualization can potentially improve ablation accuracy and safety.

Purpose of the Study:

• To assess the safety and feasibility of using closed-chest direct epicardial ultrasound imaging.
• To evaluate its utility in guiding cardiac catheter ablation procedures.

Main Methods:

• Intracardiac ultrasound catheter used for epicardial imaging in 10 patients undergoing percutaneous epicardial access.
• Utilized a double-wire technique for sheath placement and phased-array ultrasound catheter manipulation.
• Concomitant intracardiac echocardiography and preprocedural transesophageal echocardiography were performed.

Main Results:

• Excellent image stability and detailed visualization of structures like the left atrial appendage.
• No complications related to the ultrasound catheter use in the pericardium.
• Correlation of wall motion abnormalities with scar areas identified by voltage mapping.

Conclusions:

• Intrapericardial ultrasound imaging is feasible and safe.
• This technique offers potential for enhanced visualization and guidance in complex ablation procedures.