Step-by-step recommendations utilizing four-dimensional intracardiac echocardiography in left atrial appendage...

Area of Science:

• Cardiovascular Imaging
• Medical Technology

Background:

• Four-dimensional (4D) intracardiac echocardiography (ICE) is an emerging cardiac imaging technique.
• It is being explored for various procedures, including left atrial appendage occlusion (LAAO).
• 4D ICE may offer an alternative to transesophageal echocardiography (TEE) for LAAO, potentially avoiding general anesthesia.

Purpose of the Study:

• To present an optimized workflow for 4D ICE in LAAO procedures.
• To evaluate the performance of 4D ICE compared to TEE in LAAO.

Main Methods:

• Development of an optimized workflow using the NUVISION™ 4D ICE Catheter with GE ultrasound systems.
• Step-by-step procedural guide for 4D ICE in LAAO.
• Comparative analysis of 4D ICE and TEE in a single LAAO case.

Main Results:

• 4D ICE provided LAA measurements comparable to TEE.
• Superior image resolution was observed with 2D and multislice ICE modes.
• Comparable imaging quality to TEE was achieved with reduced catheter repositioning.

Conclusions:

• An optimized 4D ICE workflow facilitates efficient LAAO procedures.
• 4D ICE offers high-resolution imaging comparable to TEE for LAAO.
• This technique may serve as a viable alternative to TEE in LAAO.