Intracardiac echocardiography guidance for alcohol septal ablation in hypertrophic obstructive cardiomyopathy

Intracardiac echocardiography (ICE) was used in a 17-year-old female with refractory symptoms and hypertrophic obstructive cardiomyopathy (HOCM) to guide alcohol septal ablation. During the procedure ICE readily identified the hypertrophied interventricular septum, the dynamic intraventricular gradient, the systolic anterior motion of the mitral valve and the associated mitral regurgitation. Notably, a perfect match was demonstrated between transthoracic echocardiography and ICE findings regarding contrast location. Potential complications related to this technique and alternative therapeutic strategies are discussed. This report highlights the potential use of ICE to guide procedures of alcohol septal ablation in patients with HOCM.