Intracardiac phased-array imaging: Methods and initial clinical experience with high resolution, under blood visualization: Initial experience with intracardiac phased-array ultrasound

Douglas L Packer, Carolyn L. Stevens, Michael G. Curley, Charles J Bruce, Fletcher A Jr. Miller, Bijoy K. Khandheria, Jae Kuen Oh, Lawrence J. Sinak, James B. Seward

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Abstract

OBJECTIVES: This study was designed to test the feasibility of high-resolution phased-array intracardiac imaging. BACKGROUND: Intracardiac echocardiographic imaging of the heart during interventional electrophysiologic (EP) procedures has been limited by inadequate ultrasound penetration and absence of Doppler hemodynamic and flow information produced by rotating mechanical ultrasound elements. METHODS: A 10F (3.2 mm) phased-array, variable 5.5 to 10 MHz frequency imaging catheter with a four-way deflectable tip was applied in 24 patients undergoing EP studies. Sixteen prespecified cardiac targets were imaged from a right heart venue. RESULTS: Fifteen patients had no underlying organic heart disease; nine had ischemic, cardiomyopathic, valvular or congenital heart disorders. Longitudinal and short-axis imaging readily disclosed each cardiac valve, support structures and chamber, as well as the pericardium, right and left atrial appendages, the junction of the right atrium and superior vena cava, crista terminalis, tricuspid valve isthmus, coronary sinus orifice, membranous fossa ovalis and pulmonary veins. The average target depth was 8.8 ± 1.5 cm (range 0.5 to 15 cm), with adequate penetration at a 7.5 MHz imaging frequency. Color flow and Doppler utilities clearly characterized transaortic and pulmonic valve and pulmonary vein blood flow, including during low output states. CONCLUSIONS: These first human studies with this technology demonstrate the methods, feasibility and utility of intracardiac phased-array vector and Doppler imaging for long-axis, apex-to-base global cardiac imaging. High resolution of endocardial structures and catheters suggests additional utility for visualizing interventional procedures from the right heart.

Original languageEnglish (US)
Pages (from-to)509-516
Number of pages8
JournalJournal of the American College of Cardiology
Volume39
Issue number3
DOIs
StatePublished - Feb 6 2002

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Pulmonary Veins
Catheters
Atrial Appendage
Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Superior Vena Cava
Tricuspid Valve
Coronary Sinus
Pericardium
Heart Valves
Heart Atria
Heart Diseases
Color
Hemodynamics
Technology
Lung

ASJC Scopus subject areas

  • Nursing(all)

Cite this

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title = "Intracardiac phased-array imaging: Methods and initial clinical experience with high resolution, under blood visualization: Initial experience with intracardiac phased-array ultrasound",
abstract = "OBJECTIVES: This study was designed to test the feasibility of high-resolution phased-array intracardiac imaging. BACKGROUND: Intracardiac echocardiographic imaging of the heart during interventional electrophysiologic (EP) procedures has been limited by inadequate ultrasound penetration and absence of Doppler hemodynamic and flow information produced by rotating mechanical ultrasound elements. METHODS: A 10F (3.2 mm) phased-array, variable 5.5 to 10 MHz frequency imaging catheter with a four-way deflectable tip was applied in 24 patients undergoing EP studies. Sixteen prespecified cardiac targets were imaged from a right heart venue. RESULTS: Fifteen patients had no underlying organic heart disease; nine had ischemic, cardiomyopathic, valvular or congenital heart disorders. Longitudinal and short-axis imaging readily disclosed each cardiac valve, support structures and chamber, as well as the pericardium, right and left atrial appendages, the junction of the right atrium and superior vena cava, crista terminalis, tricuspid valve isthmus, coronary sinus orifice, membranous fossa ovalis and pulmonary veins. The average target depth was 8.8 ± 1.5 cm (range 0.5 to 15 cm), with adequate penetration at a 7.5 MHz imaging frequency. Color flow and Doppler utilities clearly characterized transaortic and pulmonic valve and pulmonary vein blood flow, including during low output states. CONCLUSIONS: These first human studies with this technology demonstrate the methods, feasibility and utility of intracardiac phased-array vector and Doppler imaging for long-axis, apex-to-base global cardiac imaging. High resolution of endocardial structures and catheters suggests additional utility for visualizing interventional procedures from the right heart.",
author = "Packer, {Douglas L} and Stevens, {Carolyn L.} and Curley, {Michael G.} and Bruce, {Charles J} and Miller, {Fletcher A Jr.} and Khandheria, {Bijoy K.} and Oh, {Jae Kuen} and Sinak, {Lawrence J.} and Seward, {James B.}",
year = "2002",
month = "2",
day = "6",
doi = "10.1016/S0735-1097(01)01764-8",
language = "English (US)",
volume = "39",
pages = "509--516",
journal = "Journal of the American College of Cardiology",
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TY - JOUR

T1 - Intracardiac phased-array imaging

T2 - Methods and initial clinical experience with high resolution, under blood visualization: Initial experience with intracardiac phased-array ultrasound

AU - Packer, Douglas L

AU - Stevens, Carolyn L.

AU - Curley, Michael G.

AU - Bruce, Charles J

AU - Miller, Fletcher A Jr.

AU - Khandheria, Bijoy K.

AU - Oh, Jae Kuen

AU - Sinak, Lawrence J.

AU - Seward, James B.

PY - 2002/2/6

Y1 - 2002/2/6

N2 - OBJECTIVES: This study was designed to test the feasibility of high-resolution phased-array intracardiac imaging. BACKGROUND: Intracardiac echocardiographic imaging of the heart during interventional electrophysiologic (EP) procedures has been limited by inadequate ultrasound penetration and absence of Doppler hemodynamic and flow information produced by rotating mechanical ultrasound elements. METHODS: A 10F (3.2 mm) phased-array, variable 5.5 to 10 MHz frequency imaging catheter with a four-way deflectable tip was applied in 24 patients undergoing EP studies. Sixteen prespecified cardiac targets were imaged from a right heart venue. RESULTS: Fifteen patients had no underlying organic heart disease; nine had ischemic, cardiomyopathic, valvular or congenital heart disorders. Longitudinal and short-axis imaging readily disclosed each cardiac valve, support structures and chamber, as well as the pericardium, right and left atrial appendages, the junction of the right atrium and superior vena cava, crista terminalis, tricuspid valve isthmus, coronary sinus orifice, membranous fossa ovalis and pulmonary veins. The average target depth was 8.8 ± 1.5 cm (range 0.5 to 15 cm), with adequate penetration at a 7.5 MHz imaging frequency. Color flow and Doppler utilities clearly characterized transaortic and pulmonic valve and pulmonary vein blood flow, including during low output states. CONCLUSIONS: These first human studies with this technology demonstrate the methods, feasibility and utility of intracardiac phased-array vector and Doppler imaging for long-axis, apex-to-base global cardiac imaging. High resolution of endocardial structures and catheters suggests additional utility for visualizing interventional procedures from the right heart.

AB - OBJECTIVES: This study was designed to test the feasibility of high-resolution phased-array intracardiac imaging. BACKGROUND: Intracardiac echocardiographic imaging of the heart during interventional electrophysiologic (EP) procedures has been limited by inadequate ultrasound penetration and absence of Doppler hemodynamic and flow information produced by rotating mechanical ultrasound elements. METHODS: A 10F (3.2 mm) phased-array, variable 5.5 to 10 MHz frequency imaging catheter with a four-way deflectable tip was applied in 24 patients undergoing EP studies. Sixteen prespecified cardiac targets were imaged from a right heart venue. RESULTS: Fifteen patients had no underlying organic heart disease; nine had ischemic, cardiomyopathic, valvular or congenital heart disorders. Longitudinal and short-axis imaging readily disclosed each cardiac valve, support structures and chamber, as well as the pericardium, right and left atrial appendages, the junction of the right atrium and superior vena cava, crista terminalis, tricuspid valve isthmus, coronary sinus orifice, membranous fossa ovalis and pulmonary veins. The average target depth was 8.8 ± 1.5 cm (range 0.5 to 15 cm), with adequate penetration at a 7.5 MHz imaging frequency. Color flow and Doppler utilities clearly characterized transaortic and pulmonic valve and pulmonary vein blood flow, including during low output states. CONCLUSIONS: These first human studies with this technology demonstrate the methods, feasibility and utility of intracardiac phased-array vector and Doppler imaging for long-axis, apex-to-base global cardiac imaging. High resolution of endocardial structures and catheters suggests additional utility for visualizing interventional procedures from the right heart.

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DO - 10.1016/S0735-1097(01)01764-8

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JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

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