INTRACARDIAC ECHOCARDIOGRAPHIC IMAGING IN GUIDING AND MONITORING RADIOFREQUENCY CATHETER ABLATION AT THE TRICUSPID ANNULUS

Intracardiac echocardiography (ICE) with lower frequency is a new imag ing modality. We present the case of a patient with dilated cardiomyop athy and recurrent supraventricular tachycardia due to a right postero lateral accessory pathway. ICE imaging was performed using a 9-MHz (9- Fr) catheter positioned in the right atrium and guided precise cathete r localization at the lateral tricuspid annulus where the bypass tract was located, which facilitated successful radiofrequency ablation. In addition, ICE imaging detected anatomic abnormalities, including Loca lized pericardial effusion and torn tricuspid chordae tendineae, which were all identified at the onset of the procedure. The effusions rema ined stable during imaging monitoring throughout rite procedure, which helped reassure as that these abnormalities were not procedure relate d. In summary, ICE imaging may significantly improve procedural effica cy in selected catheter ablation procedure and help detect anatomic ab normalities, procedural complications, or both.