Percutaneous electrophysiological interventions such as atrial fibrillation and ventricular tachycardia ablation are usually monitored by fluoroscopy and electroanatomical mapping systems. Electroanatomical mapping systems lacks soft tissue contrast and adequate visualization of the target area such as right ventricular out-flow tract and left atrium. Recently, real-time 3D transoesophageal echocardiography (RT-3D TEE) has emerged as an important method for visualizing cardiac structures such as left atrium, left atrial appendix, interatrial septum, pulmonary veins, Marshall ligament and mitral valve annulus during invasive procedures. This review aims to describe the RT-3D TEE for the guidance of percutaneous interventional electrophysiological study especially at atrial fibrillation in the cardiac electrophysiology laboratory.
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