ICE

Relate the angle of the ultrasound beam to the catheter position and surrounding anatomy.

• Advance and withdraw the catheter, rotate its shaft, and adjust deflection along two axes.
• Start in the home view or follow the simulated femoral, iliac, and caval route into the right atrium.
• Follow the path through the tricuspid valve, right ventricle, outflow tract, and pulmonary artery.
• Use the anatomy navigator and tip and beam readouts to understand what sits inside and outside the imaging plane.

Use presets to study the landmarks, then change the catheter position to see which structures come into plane.

• Compare the home view, caval and hepatic views, and the interatrial septum and fossa ovalis.
• Explore short- and long-axis views of the aortic valve, the left ventricular outflow tract, and the mitral valve.
• Locate the left atrial appendage, pulmonary veins, cavotricuspid isthmus, and right ventricular outflow tract.
• Compare right ventricular and pulmonary artery views of left-sided structures.

The simulator forms the ultrasound sector from an acoustic tissue model. Catheter motion changes the anatomy that the beam crosses.

• Set imaging depth, gain, time-gain compensation, dynamic range, frequency, and sector width.
• Tune the grayscale display with reject, persistence, gamma, and grayscale presets.
• Freeze the image and step through the cardiac phase to compare wall and valve motion.
• Explore how simulated tissue boundaries, instruments, and imaging artifacts affect the sector.

See how the same simulated flow can appear differently when viewed from another position or with another velocity scale.

• Inspect modeled flow through valves, outflow tracts, and veins during different phases of the heartbeat.
• Move, resize, or change the depth of the color box and adjust the gain and wall filter.
• Vary the Nyquist limit to see aliasing and compare flow toward and away from the transducer.

Rehearse the visual sequence of aligning the sheath, observing septal tenting, and following the simulated crossing.

• Insert and steer the virtual sheath and compare contact at the fossa with contact at the muscular rim.
• Use ICE to bring the needle into plane and compare the visible tip with an out-of-plane position.
• Observe the sheath after a simulated crossing and see how the guidewire curls when it has room in the left atrium.

Use feedback from the model to connect catheter movements, cardiac phase, and the appearance of the image.

• Distinguish a free tip from one sliding along or pressing against a wall.
• Explore modeled wall perforation and pericardial effusion in the simulator.
• Change standalone heart rate, wall motion, and respiration or observe a linked CardaxEP simulation rhythm.