4D ICE: A 2D Array Transducer with Integrated ASIC in a 10 Fr Catheter for Real-Time 3D Intracardiac Echocardiography.

We developed a 2.5 x 6.6 mm 2D array transducer with integrated transmit/receive ASIC for 4D ICE (real-time 3D IntraCardiac Echocardiography) applications. The ASIC and transducer design were optimized so that the high voltage transmit, low-voltage TGC (time-gain control) and preamp, subaperture beamformer, and digital control circuits for each transducer element all fit within the 0.019 mm2 area of the element. The transducer assembly was deployed in a 10 Fr (3.3 mm diameter) catheter, integrated with a GE Vivid1 E9 ultrasound imaging system, and evaluated in three pre-clinical studies. 2D image quality and imaging modes were comparable to commercial 2D ICE catheters. The 4D field of view was at least 90° x 60° x 8 cm and could be imaged at 30 volumes/sec, sufficient to visualize cardiac anatomy and other diagnostic and therapy catheters. 4D ICE should significantly reduce X-ray fluoroscopy use and dose during electrophysiology (EP) ablation procedures. 4D ICE may be able to replace trans-esophageal echocardiography (TEE), and the associated risks and costs of general anesthesia, for guidance of some structural heart procedures.