The Role of 3D TEE in Ablation Procedures

Complex ablations procedure might greatly benefit of an imaging technique capable of showing the anatomical details of the ‘terrain’ where the ablation takes place, guiding in real time catheter movements and continuously monitoring the catheter-tissue contact points during the energy delivery. Because 3D TEE provides high-resolution 3D images of the anatomy of the posterior structures of the heart (i.e. left and right atrium), at least in theory, this technique may have the potential to become a new, anatomy-driven navigational guide for ablation procedures. In this chapter we illustrate, normal 3D TEE anatomy of right and left atrial structures involved in ablation procedures and their anatomical variants, and then discuss the strengths and limitations of the technique during catheter ablation for typical atrial flutter and atrial fibrillation.