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Watching the Heart Work: A 4-Dimensional View in Real Time

Thursday, March 16, 2023 9:41 AM

By Susan J. White

Imagine being able to watch blood flow in and out of the heart from within the heart of a patient in real time?

That's the game-changing innovation of 4D Intracardiac Echocardiography (ICE) and the latest example of the NorthShore Cardiovascular Institute pushing the boundaries of advanced imaging to improve patient care.

Two dimensional ICE has been used for more than a decade, providing real-time imaging of the heart with catheter-based interventions and treatments like the WATCHMAN, a plug that closes off the left atrial appendage of the heart. WATCHMAN has proven to be a life saver for patients with atrial fibrillation who are not able to take blood thinners, putting them at high risk of stroke. The WATCHMAN prevents blood clots from leaving the atrial appendage/heart and causing a stroke.

The new 4D ICE device can rotate and sweep in three dimensions in real time (real time is the fourth dimension here), meaning physicians can move the catheter inside the heart less and see far more, allowing them to complete the procedure much faster with more precise visual guidance.

“We were pioneers in 2D ICE, but with this new technology we can get any angle we want and it has much higher resolution,” said NorthShore Cardiologist Mark Metzl, MD, an expert in electrophysiology.  “This is a huge advancement in intracardiac imaging. It’s like the difference between a very old TV and a new high definition one. It’s really markedly better.”

Dr. Metzl and his colleagues who are now using the new 4D ICE are thrilled about the benefits to patients and the ability to do these procedures quickly, without general anesthesia. The fact that many of the patients undergoing these procedures are older and perhaps more frail, makes these benefits even more important. Patients typically go home the same day of the procedure, he said.

As one of the first centers in the region to use the WATCHMAN ten years ago, one of the first centers in the region to use 2D ICE to guide its placement and now one of the first to use the 4D ICE.

To learn more about advanced heart technology and the NorthShore Cardiovascular Institute, click here.