Intracardiac Echocardiogram (ICE)

What is an intracardiac echocardiogram (ICE)?

An intracardiac echocardiogram (ICE) is a test that bounces high-frequency sound waves off the inside of the heart. These waves form a picture of the inner surface and valves of the heart.

When is it used?

An intracardiac echocardiogram is done to check for problems with the heart valves or inner lining of the heart. For example, it may done to look for infection or valve structures that are not normal. It may also be done during blood vessel or heart surgery to keep a constant check on the structures of the heart and blood flow to the lung. It may be used to help position catheters in the heart during procedures to treat heart rhythm problems or to close holes in the heart.

How do I prepare for the procedure?

Talk with your healthcare provider about what medicines you should take before the procedure. Your provider may prescribe medicine to prevent blood clots from forming during the procedure. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.

Follow the instructions your healthcare provider gives you. Eat a light meal the night before the procedure. You may be asked not to eat or drink anything for 12 hours before the procedure. Arrange for someone to drive you home afterward.

What happens during the procedure?

A thin, long, and flexible tube called a catheter is put through the skin in your groin, arm, or neck and into a vein. You will be given a shot to numb the area before the tube is inserted, but you will remain awake during the procedure. ICE usually takes 30 to 60 minutes.

The tube has a probe at its tip that bounces high-frequency sound waves (ultrasound) off the inside of your heart. Images of the heart can be created from the echoes of the sound waves.

Once the tube is inserted, it is guided to the proper area in your heart. When the probe is in the right place, ultrasound waves are used to create pictures of the inside of the heart and the pictures are recorded digitally or on videotape. Your healthcare provider reviews the recording to determine if there is an abnormality.

At the end of the procedure, your healthcare provider will remove the catheter and put pressure on the area where the catheter was inserted (the puncture site) to control any bleeding. The procedure takes about an hour.

What happens after the procedure?

After the procedure you may stay in an observation area for at least a few hours until there is little risk that you will have bleeding from the puncture site. After that you may go home. Avoid any strenuous activity for the rest of the day to prevent bleeding.

Ask your healthcare provider for specific instructions on how to take care of yourself at home. Ask how and when you should expect to hear your test results. Make sure you know when you should come back for a checkup.

A bruise may appear near the puncture site and be uncomfortable for a few days.

What are the benefits of this procedure?

The pictures created by ICE show the location of important structures within the heart. ICE may show disease not well seen by other tests. Your healthcare provider uses this information to decide what treatment may be best for you. The views of the inside of the heart can also be helpful during some surgical procedures.

What are the risks of this procedure?

Possible risks include:

• The procedure can cause irregular heart rhythms, which could need treatment.
• If the catheter is placed in an artery, a blood clot could form around the catheter and block the artery.
• You may have bleeding where the catheter was inserted into your blood vessel.
• The catheter may damage a blood vessel.
• In rare cases, you may have an allergic reaction to the drug used in the anesthesia.
• While not common, a heart attack or stroke might be triggered by the procedure.

You should ask your healthcare provider how these risks apply to you.

Because the ICE catheter is positioned inside the heart, there is a risk that the catheter will cause a heart attack. Talk to your provider for complete information about how the risks apply to you.

When should I call my healthcare provider?

• The place where the catheter was put into your skin begins to bleed or swell, or it becomes more painful.
• Your leg or foot becomes cool or cold.
• You have slurred speech, balance problems, or trouble using your arm or leg.
• You develop a rash, itching, sweating, or trouble breathing.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.

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