Catheter ablation of outflow tract ventricular arrhythmia with intracardiac echocardiography assistance

As the indications for catheter-based electrophysiologic procedures become more diverse and complex, accurate assessment of the anatomy of intracardiac structure has become essential for the optimal clinical outcome. Since intracardiac echocardiography (ICE) was first introduced in 1980, it has become an integral part of various electrophysiologic procedures enabling accurate visualization of cardiac structures and continuous monitoring of catheter position, with integration of real-time images and electroanatomic mapping. Catheter ablation for outflow tract ventricular arrhythmias (OTVAs) has been actively performed in symptomatic patients. However, the anatomic complexity of OT serves as the biggest obstacle to obtain the optimal results. In OTVAs, ICE has played an invaluable role in precisely defining the anatomic shell of OT beyond fluoroscopy and in guiding catheter manipulation in relation to critical structures like the conduction system and coronary arteries. This review article provides detailed information on comprehensive application of ICE for catheter ablation of OTVAs.