Electrophysiology Laboratory Survival Guide Part 2: Introduction to Intracardiac Echocardiography in the Electrophysiology Laboratory.

Intracardiac echocardiography (ICE) is a catheter-based ultrasound probe that is used in the cardiac electrophysiology laboratory for real-time assessment of cardiac structures during electrophysiological studies. ICE requires additional vascular access, but provides real-time intracardiac analysis of cardiac structures. The imaging sector of ICE creates a fan from the side of the catheter tip that is perpendicular along the long axis of the ICE catheter, different from standard echocardiographic images. The near-field image shows structures proximal along the long axis of the catheter, whereas the far-field image shows structures distal along the long axis. The home view for ICE imaging has the catheter within the right atrium facing the tricuspid valve in the neutral position, with additional views obtained with clockwise rotation of the catheter. Careful attention is required when advancing the catheter in the body and interpreting the ICE images.