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David R. Holmes, Jr, MD*,
Rick Nishimura, MD,
Rebecca Fountain, RN,
Zoltan G. Turi, MD
We thank Drs. Ren and Marchlinski for the interest in our paper (1). The most important aspect of pericardial effusion is prompt and early recognition, which then facilitates rapid treatment. A number of different diagnostic modalities are available that can facilitate this process. Certainly intracardiac echocardiography can be very helpful although it is not routinely used in all laboratories. It can be used to facilitate transseptal approaches as has been mentioned and can be used for early diagnosis of effusion. We use it often in complex cases involving pulmonary vein ablation, pulmonary vein stenosis, left atrial appendage occlusion, paravalvular leaks, among other situations. It is very helpful, although not perfect.
It is important to remember that like any other technical or imaging procedure, intracardiac echocardiography is not perfect, and one should not make the mistake of thinking that it makes procedures that can be complex into very easy risk-free adventures. Careful attention to detail, knowledge about the risks and benefits of each procedure, and awareness of complications is essential to optimize outcome. As part of the armamentarium of interventional cardiologists, intracardiac echocardiography is a wonderful addition.
* Mayo Clinic, Cardiovascular Diseases and Internal Medicine, 200 First Street, SW, MB 4-523, Rochester, Minnesota 55905 (Email: holmes.david{at}mayo.edu).
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- Holmes Jr. DR, Nishimura R, Fountain R, Zoltan G. Iatrogenic pericardial effusion and tamponade in the percutaneous intracardiac intervention era J Am Coll Cardiol Intv 2009;2:705-717.[Abstract/Free Full Text]
Related Article
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Early Detection of Iatrogenic Pericardial Effusion: Importance of Intracardiac Echocardiography
- Jian-Fang Ren and Francis E. Marchlinski
J. Am. Coll. Cardiol. Intv. 2010 3: 127.
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