Considerations for the Use of Intracardiac Echocardiography in Cardiac Arrest

Abstract

The use of transthoracic echocardiography (TTE) is common during cardiopulmonary resuscitation (CPR) from cardiac arrest, but logistic and practical challenges of obtaining satisfactory images without sacrificing the quality of CPR have resulted in some centers utilizing transesophageal echocardiography (TEE) during CPR. Although TEE avoids many of the downsides of TTE, several challenges exist in routine deployment. An alternative approach, intracardiac echocardiography (ICE), is routinely used by electrophysiologists during regular cardiac electrophysiologic procedures, such as atrial ablation for the treatment of atrial fibrillation. In this review, we evaluate various considerations in the potential for use of ICE as a novel means of enhancing resuscitation during CPR.

Keywords: Cardiopulmonary resuscitation; Emergency Department; advanced cardiac life support; aortic valve; cardiac tamponade; intracardiac echocardiography; left ventricle; left ventricular function; left ventricular outflow tract; mitral valve; pericardial effusion; point-of-care ultrasound; return of spontaneous circulation; right atrium; right ventricle; right ventricular function; transesophageal echocardiography; transthoracic echocardiography; tricuspid valve; ventricular fibrillation.