Intracardiac echocardiography in electrophysiology: a review of current applications in practice

Intracardiac echocardiography (ICE) has emerged as a widespread useful tool in the everyday practice of interventional electrophysiology. Advances in catheter-based ultrasound transducers and imaging technology have made this modality integral to guiding evaluation of anatomy and ablation therapy. Evolution of ablative procedures of the left heart for tachyarrhythmia has highlighted the importance of direct visualization of anatomic landmarks to guide transseptal catheterization and immediately identify complications. The ability to position mapping and ablation catheters according to anatomic landmarks (Fig. 1) has greatly enhanced the safety and efficacy of catheter ablation procedures. ICE has supplanted fluoroscopy as the gold standard for precise imaging of endocardial structures during complex procedures.