ICE less sensitive than TEE in detecting LA appendage thrombus
ICE less sensitive than TEE in detecting LA appendage thrombus: Intracardiac echo is now being increasingly used to guide interventional procedures, especially in the field of electrophysiology. The Intracardiac Echocardiography Guided Cardioversion Helps Interventional Procedures (ICE-CHIP) study was a direct comparison between intracardiac echocardiography (ICE) and trans esophageal echocardiography (TEE) by Sanjeev Saksena, Jasbir Sra, Luc Jordaens, Fred Kusumoto, Bradley Knight, Andrea Natale, Abraham Kocheril, Navin C Nanda, Rangadham Nagarakanti, Ann Marie Simon, Mary A Viggiano, Tasneem Lokhandwala and Mary L Chandler, the ICE-CHIP Investigator Study Group .
The study prospectively evaluated the efficacy of both techniques in assessing the left atrium and interatrial septum in 95 patients. The concordance of image quality between the two techniques for imaging the left atrium was 96%. Detection of spontaneous echo contrast in the left atrium was similar by both methods. But imaging of left atrial appendage was better with trans esophageal echo (96%) than intracardiac echo (85%). Intracardiac thrombus was uncommon in the study (TEE, 6.9%; ICE, 5.2%). Left atrial appendage thrombus was detected more often with TEE rather than ICE.
- Sanjeev Saksena, Jasbir Sra, Luc Jordaens, Fred Kusumoto, Bradley Knight, Andrea Natale, Abraham Kocheril, Navin C Nanda, Rangadham Nagarakanti, Ann Marie Simon, Mary A Viggiano, Tasneem Lokhandwala, Mary L Chandler, ICE-CHIP Investigator Study Group. A prospective comparison of cardiac imaging using intracardiac echocardiography with transesophageal echocardiography in patients with atrial fibrillation: the intracardiac echocardiography guided cardioversion helps interventional procedures study. Circ Arrhythm Electrophysiol. 2010 Dec;3(6):571-7.