Intracardiac contrast echoes during transvenous His bundle ablation

Area of Science:

• Cardiology
• Medical Imaging
• Electrophysiology

Background:

• Endocavitary ablation is a treatment for supraventricular tachycardia.
• Echocardiography is used to visualize heart structures and blood flow.

Purpose of the Study:

• To describe an observed contrast effect during endocavitary ablation for supraventricular tachycardia.
• To evaluate the potential implications of this contrast effect, particularly regarding embolization risk.

Main Methods:

• Cross-sectional echocardiography was performed during endocavitary ablation in two patients.
• The contrast effect observed was compared to standard echocardiographic contrast studies for intracardiac shunts.

Main Results:

• Immediate opacification of the right heart cavities occurred in both patients during the procedure.
• In one patient, contrast echoes were also visualized in the left ventricle.
• The observed contrast effect mimicked that seen with peripheral venous injections for shunt detection.

Conclusions:

• The contrast effect observed during endocavitary ablation may result from gaseous release or blood element destruction.
• There is a potential risk of embolization associated with endocavitary ablation, particularly for left-sided procedures.
• Further research is needed to fully evaluate the risks of embolization in patients undergoing endocavitary ablation.