ICE Catheter as Transesophageal Probe in Children With Congenital Heart Disease Undergoing an Electrophysiology Study

Q4 Medicine

JACC. Case reports Pub Date : 2026-10-21 Epub Date: 2026-08-20 DOI:10.1016/j.jaccas.2026.109907

David Bienjonetti-Boudreau MD, Jonathan Smerling MD, Shankar Baskar MD, David S. Spar MD, Richard J. Czosek MD, Chad Connor MD

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Abstract

Background

Intracardiac echocardiography (ICE) is conventionally used as an endovascular imaging modality during electrophysiology procedures. Reports of transesophageal ICE are limited and have not included pediatric electrophysiology procedures.

Case Summary

We report the first case series of transesophageal ICE (NuVision NAV) in 6 infants and young children with congenital heart disease undergoing electrophysiology studies and catheter ablation. Indications included preoperative conduction mapping and clinical arrhythmias.

Discussion

Transesophageal placement preserves the imaging advantages of ICE while avoiding large-bore venous access in small children without compromising image quality. The technique facilitates electroanatomic mapping by providing accurate delineation of the atrioventricular annulus in patients with complex congenital heart disease.

Take-Home Message

Transesophageal ICE with four-dimensional multiplanar imaging provides high-quality real-time anatomical guidance for electrophysiology procedures in infants and young children with complex congenital heart disease and may offer a practical alternative to intravascular ICE when large-bore venous access is undesirable.

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ICE导管作为经食道探头在先天性心脏病患儿中的电生理学研究

背景：心内超声心动图（ICE）通常被用作电生理过程中的血管内成像方式。经食道ICE的报道是有限的，没有包括儿童电生理手术。病例总结：我们报告了6例先天性心脏病婴幼儿经食管ICE （NuVision NAV）的首个病例系列，他们接受了电生理研究和导管消融。适应症包括术前传导测图和临床心律失常。讨论：经食管置管保留了ICE的成像优势，同时避免了儿童的大口径静脉通路，同时不影响图像质量。该技术通过提供复杂先天性心脏病患者房室环的准确描绘，促进了电解剖制图。关键信息：经食管ICE的四维多平面成像为患有复杂先天性心脏病的婴幼儿的电生理手术提供了高质量的实时解剖指导，当不需要大口径静脉通道时，可能是血管内ICE的实用替代方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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