Intracardiac echo (ICE) helps in diagnosis of cardiac implantable device related endocarditis

Intracardiac echo (ICE) helps in diagnosis of cardiac implantable device related endocarditis

Detection of vegetations on prosthetic material within the heart is often difficult as these structures may cause acoustic shadowing and reverberation artifacts. Even though trans esophageal echocardiography is better than trans thoracic echocardiography in detecting intracardiac vegetations, intracardiac echo may have an additional advantage due to the higher resolutions possible.

Intracardiac echo uses transducer frequencies in the range of 5 – 12 MHz and probes of 6 – 10F sizes, which can be introduced into the right sided cardiac chambers through the femoral vein and inferior vena cava. A study by Maria et al had [1] evaluated one hundred and sixty two patients who underwent lead extraction, of which one hundred and fifty two had device related infection and ten had lead malfunction. The detection of intracardiac masses suggesting vegetations were higher with intracardiac than with trans esophageal echocardiography.

Reference

1. Maria Lucia Narducci, Gemma Pelargonio, Eleonora Russo, Leonardo Marinaccio, Antonio Di Monaco, Francesco Perna, Gianluigi Bencardino, Michela Casella, Luigi Di Biase, Pasquale Santangeli, Rosalinda Palmieri, Christian Lauria, Ghaliah Al Mohani, Francesca Di Clemente, Claudio Tondo, Faustino Pennestri, Carolina Ierardi, Antonio G Rebuzzi, Filippo Crea, Fulvio Bellocci, Andrea Natale, Antonio Dello Russo. Usefulness of Intracardiac Echocardiography for the Diagnosis of Cardiovascular Implantable Electronic Device-Related Endocarditis. J Am Coll Cardiol. 2013 Apr 2;61(13):1398-405.