Dello Russo A, Casella M, Pelargonio G, Bonelli F, Santangeli P, Fassini G, Riva S, Carbucicchio C, Giraldi F, De Iuliis P, Bartoletti S, Pintus F, Di Biase L, Pepi M, Natale A, Fiorentini C, Tondo C
Cardiac Arrhythmia Research Center, Centro Cardiologico Monzino, Department of Cardiovascular Research, University of Milan, Milan, Italy.
Minerva Cardioangiol. 2010 Jun;58(3):333-42.
Intracardiac echocardiography (ICE) is a recent, invaluable tool which can provide real-time anatomical guidance in electrophysiological procedures. By inserting intravenously an ultrasound probe and advancing it into the heart, various different views can be obtained which allow to better visualize patient anatomy, to guide the placement of electrophysiological catheters, and to detect immediately procedural complications as they occur. In atrial fibrillation ablation, ICE proves particularly useful to achieve a safer trans-septal puncture (especially in the presence of anatomical anomalies of the interatrial septum) and to help to monitor the visualization of the mapping catheters (circular, high density), or the monitoring of the balloons catheter (Cryo, Laser) position. In ventricular tachycardia ablation, on the other hand, ICE allows for continuous correlation between electrophysiological and structural findings (such as wall motion anomalies or changes in echodensity), and helps to ensure correct catheter contact and to position it, particularly around delicate structures such as the aortic cusps. In any procedure, ICE is also useful to immediately detect procedural complications, such as thrombus formation along catheters, or pericardial effusion. Thanks to its real-time morphological information, ICE provides an ideal complement to simple fluoroscopy or to more complex electroanatomic mapping techniques and is set to gain a wider role in a broad range of electrophysiological procedures.
心腔内超声心动图（ICE）是一种最新的、极为重要的工具，它能够在电生理手术中提供实时解剖学指导。通过静脉插入超声探头并将其推进至心脏，可以获得各种不同的视图，从而能够更好地观察患者的解剖结构，指导电生理导管的放置，并在手术并发症发生时立即进行检测。在房颤消融术中，ICE被证明在实现更安全的经房间隔穿刺（尤其是在存在房间隔解剖异常的情况下）以及帮助监测标测导管（环形、高密度）的可视化或球囊导管（冷冻、激光）位置的监测方面特别有用。另一方面，在室性心动过速消融术中，ICE能够实现电生理和结构发现（如室壁运动异常或回声密度变化）之间的持续关联，并有助于确保导管正确接触和定位，特别是在诸如主动脉瓣叶等精细结构周围。在任何手术中，ICE对于立即检测手术并发症（如沿导管形成血栓或心包积液）也很有用。由于其提供的实时形态学信息，ICE为简单的荧光透视或更复杂的电解剖标测技术提供了理想的补充，并将在广泛的电生理手术中发挥更广泛的作用。
