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(Circulation. 2009;119:587-596.)
© 2009 American Heart Association, Inc.

Contemporary Reviews in Cardiovascular Medicine

Intracardiac Echocardiography During Interventional and Electrophysiological Cardiac Catheterization

Ziyad M. Hijazi, MD, MPH; Kalyanam Shivkumar, MD, PhD; David J. Sahn, MD

From the Rush Center for Congenital and Structural Heart Disease, Rush University Medical Center, Chicago, Ill (Z.M.H.); UCLA Cardiac Arrhythmia Center, David Geffen School of Medicine at UCLA, Los Angeles, Calif (K.S.); and Department of Pediatrics (Cardiology) and Biomedical Engineering, Oregon Health & Science University, Portland, Ore (D.J.S.).

Correspondence to David J. Sahn, MD, FAHA, L608, Pediatric Cardiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098. E-mail sahnd@ohsu.edu

Key Words: arrhythmia • catheter ablation • diagnosis • echocardiography • imaging

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Just as the growing interest and proliferation of methods to reperfuse the coronary artery system with transcatheter techniques spurred interest and utilization of intracoronary ultrasound (at least in academic centers), so the growth of anatomic cardiac transcatheter interventions and increasingly aggressive transcatheter ablative strategies to treat cardiac arrhythmias has stimulated the use of and development of new methods for intracardiac echocardiography (ICE). This article will review the development, present state of the art, and applications of ICE as well as project its evolution from 2-dimensional to 3-dimensional/4-dimensional visualization and integration of therapy with imaging in the near future.

	History and Evolution of ICE

 
It may be surprising to realize that in the earliest days of ultrasound, as early as 1956, the potential of imaging heart structures with catheter-based devices was explored.¹ The earliest investigators used single-crystal probes, some of which were rotated to achieve cardiac imaging.^2,3 In the mid-1960s, a mechanically rotating 4-element probe was developed by Eggleton et al,⁴ and in 1969, a 32-element phased-array coil was developed by Bom and coworkers^5,6 in Rotterdam.

These interests even preceded the development of interventional catheterization therapy. They were spurred by the problems of angiography in outlining vascular and intracardiac anatomy in large detail as single-plane and eventually biplane angiography. The goal was precise measurement of vascular lumens.

Some of the early explorations of intracardiac imaging with phased-array technology and color Doppler were undertaken with miniaturized transesophageal studies in experimental animals.⁷ Higher-frequency rotating catheter probes in the range of 20 to 30 MHz were developed and marketed . . . [Full Text of this Article]

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