SCAI Position Statement Addresses Intracardiac Echocardiography

October 7, 2025—The Society for Cardiovascular Angiography & Interventions (SCAI) announced the release of a position statement outlining best practices for using intracardiac echocardiography (ICE) to guide structural heart disease interventions. The document examines the advantages, limitations, and best practices for ICE in procedures such as mitral, tricuspid, and pulmonary valve interventions; left atrial appendage closure; atrial septal defect closure; and patent foramen ovale closure, stated SCAI.

Mackram F. Eleid, MD, et al published the document in JSCAI. Dr. Eleid, who is an interventional cardiologist at Mayo Clinic in Rochester, Minnesota, served as Chair of the SCAI position statement writing group.

According to SCAI, the document provides interventionists with a structured approach to integrating ICE into their practice by offering standardized ICE imaging protocols and views tailored to specific interventions. Additionally, training pathways for physicians are emphasized, including the need for workflow redesign within catheterization labs, and institutional readiness to ensure safe and effective implementation.

In contrast to traditional transesophageal echocardiography (TEE), ICE provides clinicians with real-time, high-resolution imaging from inside the heart without the need for general anesthesia, noted the society.

Additionally, SCAI advised that the statement highlights ongoing barriers to adoption, particularly those related to reimbursement, as current coding does not fully account for the complexity of ICE-guided procedures or the role of interventional imaging specialists.

The position statement writing group urged policymakers to update reimbursement models so that hospitals and physicians are appropriately supported in offering ICE. The position statement also called for further comparative studies of ICE and TEE, particularly in mitral and tricuspid interventions, where evidence is still emerging, stated SCAI.