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First-in-Human Use of a Novel 4D Intracardiac Echocardiography Catheter To Guide Interventional Electrophysiology Procedures
  • +11
  • Rachel Kaplan,
  • Akhil Narang,
  • Hawkins Gay,
  • Xu Gao,
  • Mohammed Gibreal,
  • Rishi Arora,
  • Alexandru Chicos,
  • Susan Kim,
  • Rod Passman,
  • Kaustubha Patil,
  • Anna Pfenniger,
  • Nishant Verma,
  • Albert Lin,
  • Bradley Knight
Rachel Kaplan
Northwestern University Feinberg School of Medicine

Corresponding Author:rachel.kaplan@nm.org

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Akhil Narang
Northwestern University Feinberg School of Medicine
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Hawkins Gay
Northwestern University Feinberg School of Medicine
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Xu Gao
Northwestern University Feinberg School of Medicine
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Mohammed Gibreal
Northwestern University Feinberg School of Medicine
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Rishi Arora
Northwestern University Feinberg School of Medicine
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Alexandru Chicos
Northwestern University Feinberg School of Medicine
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Susan Kim
Northwestern University Feinberg School of Medicine
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Rod Passman
Northwestern University Feinberg School of Medicine
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Kaustubha Patil
Northwestern University Feinberg School of Medicine
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Anna Pfenniger
Northwestern University Feinberg School of Medicine
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Nishant Verma
Northwestern University Feinberg School of Medicine
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Albert Lin
Northwestern University Feinberg School of Medicine
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Bradley Knight
Northwestern University Feinberg School of Medicine
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Abstract

Introduction: Standard two-dimensional (2D), phased-array intracardiac echocardiography (ICE) is routinely used to guide interventional electrophysiology (EP) procedures. A novel four-dimensional (4D) ICE catheter (VeriSight Pro®, Philips, Andover, MA) can obtain 2D and three-dimensional (3D) volumetric images and cine-videos in real time (4D). The purpose of this study was to determine the early feasibility and safety of this 4D ICE catheter during EP procedures. Methods: The 4D ICE catheter was placed from the femoral vein in ten patients into various cardiac chambers to guide EP procedures requiring transseptal catheterization, including ablation for atrial fibrillation and left atrial appendage closure. 2D- and 3D- ICE images were acquired in real time by the electrophysiologist. A dedicated imaging expert performed digital steering to optimize and post-process 4D images. Results: Eight patients underwent pulmonary vein isolation (cryoballoon in 7 patients, pulsed field ablation in 1, additional radiofrequency left atrial ablation in 1). Two patients underwent left atrial appendage closure. High quality images of cardiac structures, transseptal catheterization equipment, guide sheaths, ablation tools, and closure devices were acquired with the ICE catheter tip positioned in the right atrium, left atrium, pulmonary vein, coronary sinus, right ventricle, and pulmonary artery. There were no complications. Conclusion: This is the first-in-human experience of a novel deflectable 4D ICE catheter used to guide EP procedures. 4D ICE imaging in safe and allows for acquisition of high-quality 2D and 3D images in real-time. Further use of 4D ICE will be needed to determine its added value for each EP procedure type.
19 Aug 2021Submitted to Journal of Cardiovascular Electrophysiology
20 Aug 2021Submission Checks Completed
20 Aug 2021Assigned to Editor
21 Aug 2021Reviewer(s) Assigned
22 Aug 2021Review(s) Completed, Editorial Evaluation Pending
23 Aug 2021Editorial Decision: Revise Minor
06 Sep 20211st Revision Received
09 Sep 2021Submission Checks Completed
09 Sep 2021Assigned to Editor
09 Sep 2021Reviewer(s) Assigned
13 Sep 2021Review(s) Completed, Editorial Evaluation Pending
15 Sep 2021Editorial Decision: Accept