PO-696-06 REAL-WORLD EXPERIENCE WITH A NOVEL 3D INTRACARDIAC ECHOCARDIOGRAPHY CATHETER

Abstract

Intracardiac echocardiography (ICE) is a valuable imaging modality which allows real-time visualization of cardiac anatomy for procedural guidance. The NUVISION™ 4D ICE catheter (Biosense Webster Inc, Irvine, CA) is a novel 10-Fr catheter with fully sampled matrix phased-array transducer capable of real-time 3D imaging. A unique feature of the catheter is the presence of a dedicated knob, which allows independent 360° rotation of the tip. To describe the performance of the NUVISIONTM catheter during different electrophysiology procedures. We included 50 consecutive patients scheduled for electrophysiology procedures between September and November 2021. The primary endpoint was a composite of safety (device-related complications) and efficacy (acute procedural success). A 5-point Likert scale was used to rate the experience with transseptal (TS) access, catheter maneuverability, image quality. Among 50 patients (mean age 70±11, 22% female), 38 (76%) underwent left atrial appendage (LAA) occlusion, 6 (12%) AF ablation, 3 (6%) VT/PVC ablation, and 3 (4%) LAA leak closure with either coils (n=1; 2%) or radiofrequency applications (n=2; 4%). The ICE catheter was advanced through an 11-Fr sheath into the left femoral vein; no access-related complications occurred. TS access was performed in 47 patients (single access: 14 pts; double access: 33 pts). Mean time for each TS access was 3.4±0.7 min; ICE catheter performance during TS was rated as “very good” in 87.2% of cases. Maneuverability was rated as “very good” in 84% of cases; of note, the percentage of “very good” ratings rose from 72% to 96% between the first and the last 25 cases, as a result of the better familiarity and increasing satisfaction of the operators with the rotation knob. The catheter was advanced into the left atrium in 38 LAA procedures. A multiplanar view (Figure 1) was the imaging modality of choice (81.6%) for LAA sizing and during device deployment. A single device was attempted in all patients; 4 patients required device recapture and repositioning. Image quality was rated as “very good” in 98% of cases. No device-related complications occurred; acute procedural success was achieved in all. The NUVISIONTM 3D ICE catheter was safe and may significantly improve procedural guidance.