Stepwise approach for visualization and reconstruction of pulmonary valve with intracardiac echocardiography

• Published in: Pacing and clinical electrophysiology Vol. 44; no. 7; pp. 1267 - 1276
• Main Authors: De Sensi, Francesco, Addonisio, Luigi, Miracapillo, Gennaro, Breschi, Marco, Cresti, Alberto, Limbruno, Ugo
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2021
• Subjects: Ablation; Aortic valve; Cardiac arrhythmia; Cardiac Surgical Procedures - methods; Coronary artery; Coronary artery disease; Echocardiography; Heart diseases; Humans; Imaging, Three-Dimensional; intracardiac echocardiography; outflow tract ventricular arrhythmias; Pulmonary arteries; Pulmonary artery; Pulmonary Valve - diagnostic imaging; Pulmonary Valve - surgery; pulmonary valve PVCs; Radiofrequency ablation; Rheumatic heart disease; Surgery, Computer-Assisted; Tachycardia; Ventricle; pulmonary valve PVCs; intracardiac echocardiography; outflow tract ventricular arrhythmias
• ISSN: 0147-8389; 1540-8159
• DOI: 10.1111/pace.14233

Ventricular tachycardia and premature ventricular complexes (PVCs) arising from right ventricular outflow tract (RVOT) are the most common type of ventricular arrhythmias (VAs) in patients without structural heart disease. Radiofrequency ablation is now the gold standard of treatment in this setting due to high efficacy rates and optimal safety profile. During the last few years, the pulmonary valve (PV) and the pulmonary artery (PA) have attracted much attention as reliable sites of origin of RVOT‐type arrhythmias. In the mean while intracardiac echocardiogram (ICE) has undoubtedly improved our understanding of the cardiac anatomy. Aim of this paper is to provide an illustrated step‐by‐step guide on how to use ICE with the CARTOSOUND module to visualize and reconstruct 3D shell of the RV, the PV, as well of other contiguous anatomical structures (i.e., the aortic valve and coronary arteries) to perform aware and safe ablation in this region.