What is an Intracardiac Echocardiography?
Intracardiac Echocardiography, commonly known as ICE, is a specialized imaging technique that uses a miniature ultrasound catheter inserted directly into the heart to capture detailed, real-time images of cardiac structures. Unlike traditional echocardiograms performed from outside the body, ICE provides a view from within the heart itself, giving physicians an exceptionally clear picture of anatomy and activity during complex cardiac procedures.
At the Heart Rhythm Institute of Arizona, Dr. Beshai refers to ICE as the “Intricacies Ultrasound” because it allows him to navigate the intricate inner landscape of the heart with a level of precision that simply cannot be achieved with external imaging alone. This technology has transformed the way advanced heart rhythm procedures are performed, offering a safer and more targeted approach for eligible patients.
Why is an Intracardiac Echocardiography Done?
ICE is used to enhance the safety, accuracy, and effectiveness of certain cardiac procedures. When Dr. Beshai is working inside the heart, having live ultrasound guidance from within that same space removes guesswork and improves outcomes. ICE serves several essential purposes during a procedure:
- Visualizing cardiac structures internally, including the walls, valves, and chambers of the heart, in real time
- Guiding transseptal puncture, the delicate step of crossing from one side of the heart to the other, with greater confidence and reduced risk
- Confirming device positioning to ensure that implanted or deployed devices are placed exactly where they need to be
- Reducing or eliminating the need for transesophageal echocardiography (TEE) in certain cases, sparing patients from the discomfort of a probe placed down the throat and the need for deeper sedation
By providing this level of visibility, ICE helps minimize complications and allows your care team to make immediate, informed decisions throughout the procedure.
When is an Intracardiac Echocardiography Needed?
ICE is most commonly used in conjunction with two procedures offered at the Heart Rhythm Institute of Arizona:
- Atrial Fibrillation Ablation: During an AFib ablation, Dr. Beshai uses heat or cold energy to isolate abnormal electrical pathways in the heart that are triggering irregular rhythms. ICE provides continuous imaging throughout this process, helping to map the cardiac anatomy and confirm that energy is being delivered safely and accurately to the correct areas.
- Watchman Procedure: The Watchman is a small device implanted in the left atrial appendage, a pouch-like structure where blood clots frequently form in patients with atrial fibrillation. ICE helps Dr. Beshai visualize the appendage and confirms that the Watchman device is placed securely before it is released.
Dr. Beshai will determine whether ICE is appropriate for your specific situation based on the type of procedure planned, your individual anatomy, and other clinical factors.
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How is an Intracardiac Echocardiography Performed?
ICE is not a standalone procedure. Rather, it is performed as part of a larger cardiac intervention. The process unfolds in a carefully monitored setting and involves the following:
- Preparation: You will be positioned on a procedure table, and an IV line will be placed. You will receive sedation or anesthesia appropriate for the planned procedure. Your heart rate, blood pressure, and oxygen levels will be monitored throughout.
- Catheter Placement: A small, flexible catheter containing a miniature ultrasound transducer is inserted through a vein in the groin and guided up into the right side of the heart. No incisions are required.
- Real-Time Imaging: Once the ICE catheter is in position, it begins transmitting live ultrasound images to monitors in the procedure room. Dr. Beshai will use these images to navigate the heart, guide instruments, and monitor for any changes throughout the case.
- Completion: When the primary procedure is finished, the ICE catheter is gently withdrawn. The access site is compressed and monitored to ensure proper closure before you are moved to recovery.
What are the Next Steps After an Intracardiac Echocardiography?
Because ICE is performed as part of a larger procedure, your recovery and follow-up will be guided primarily by the treatment you received. After your procedure, you will be monitored in a recovery area while the sedation wears off and your vital signs stabilize. Most patients are able to return home the same day or within one night, depending on the procedure performed and how they are feeling.
You will receive specific discharge instructions regarding activity restrictions, wound care at the groin access site, and any medications you should continue or begin. A follow-up appointment with Dr. Beshai will be scheduled to review how your heart is responding and to discuss any additional steps in your care plan.
Our team is committed to supporting you from before the procedure and through to your full recovery. We are always available to answer questions and address concerns as you heal.
Schedule Your Intracardiac Echocardiography Consultation
If you have been diagnosed with atrial fibrillation or are exploring options for stroke prevention and have questions about the Watchman procedure or AFib ablation, the Heart Rhythm Institute of Arizona is here to help. Dr. Beshai and his team will take the time to understand your unique situation, explain all available options, and determine whether a procedure incorporating intracardiac echocardiography is appropriate for you.
You deserve care that is as precise as it is compassionate. Contact us today to schedule a consultation and take the next step toward a healthier heart.
The Heart Institute of Arizona has a wide array of services that come with our premium care. From in-office dianostics and treatable conditions, to hospital based procedures, we’ve got your heart covered.
Dr. Beshai is a board-certified electrophysiologist internationally renowned and respected for his expertise and research. Having published in major medical journals and travelled all over the world to present research, he is dedicated to providing innovative, state-of-the-art care to his patients.