A Prospective Comparison of Cardiac Imaging Using Intracardiac Echocardiography with TransEsophageal Echocardiography in Patients with Atrial Fibrillation: The Intra-Cardiac Echocardiography Guided Cardioversion Helps Interventional Procedures (ICE-CHIP) Study.
Circ Arrhythm Electrophysiol. 2010 Sep 18;
Authors: Saksena S, Sra J, Jordaens L, Kusumoto F, Knight B, Natale A, Kocheril A, Nanda NC, Nagarakanti R, Simon AM, Viggiano MA, Lokhandwala T, Chandler ML
BACKGROUND: -The Intracardiac Echocardiography guided Cardioversion Helps Interventional Procedures study evaluated the concordance of intracardiac echocardiography (ICE) as compared to transesophageal echocardiography (TEE) in patients with atrial fibrillation. METHODS AND RESULTS: -Patients with atrial fibrillation undergoing right heart catheterization underwent left atrium (LA) and inter-atrial septal (IAS) imaging by TEE and ICE. A blinded comparison of the two modalities was performed at a core laboratory. 95 patients, mean age 58Â±12 years completed the study. The LA was profiled in all patients with both techniques and concordance for image quality was 96%. LA appendage(LAA) imaging was achieved in 85% with ICE and 96% with TEE. There was no difference in the presence of spontaneous echo contrast between ICE and TEE during LA imaging but there was a trend toward greater incidence in the LAA with TEE (p=0.109). Intracardiac thrombus was uncommonly seen (TEE-6.9%, ICE-5.2%). The concordance for the presence or absence of thrombus was 97% in the LA and 92% in the LAA but the latter was more frequently detected with TEE. IAS imaging with ICE was achieved in 91% with ICE and 97% with TEE (p=0.177). Concordance for patent foramen ovale and atrial septal aneurysms was 100% and 96% respectively. A negative ICE examination was associated with absence of dense echo contrast or thrombus on TEE in 86%. CONCLUSIONS: -We conclude that this study provides validation for the use of ICE for LA and IAS imaging. ICE imaging was less sensitive compared to TEE for LAA thrombus identification. Clinical Trial Registration-www.clinical trials.gov; NCT00281073.
PMID: 20852299 [PubMed - as supplied by publisher]