Mansour Razminia, MD, has not used X-ray for a single cardiac procedure in more than 16 years, all thanks to a technique that has given him the global nickname of “ICE King.”
Dr. Razminia, a cardiac electrophysiologist and medical director of electrophysiology for the Bluhm Cardiovascular Institute at Northwestern Medicine Palos Hospital in Palos Heights, Ill., has exclusively used intracardiac echocardiography, or ICE, on thousands of cardiac surgeries.
“ICE is essential — it allows us to see our catheters and visualize their contact with heart tissue in real time,” he said on an episode of Becker’s “Cardiology and Heart Surgery Podcast.” “December 8, 2010, was the last day I ever used X-ray. Since then, I have performed over 7,500 consecutive ablation procedures without a single exposure. Electrophysiology has had its Ford Model T. It’s time for the Tesla.”
ICE has been around for decades, but Dr. Razminia has been pioneering its use all while working at community hospitals. ICE has several advantages: It is safe for pregnant patients and for clinicians, and it reduces radiation exposure for all. This is especially notable as more physicians and medical associations push hospitals to move away from heavy lead aprons to protect staff from radiation exposure.
“I don’t know of a single academic center today that performs all of its EP procedures — including Watchman implantation — without X-ray,” he said. “If you’re working in the right ventricle, place it there. When you do that, X-ray becomes not just unnecessary — it becomes useless. All it shows you is a rib shadow, two lungs, and a catheter drifting right and left. It has no meaningful role in that procedure once you know what ICE can do.”
That is why Dr. Razminia regularly travels the nation and the world to teach physicians the technique.
“It has been a 16-year effort to move this field,” he said. “The Heart Rhythm Society and other major societies are overdue to engage seriously with this. My hope is that they do — because every fellow trained today without this foundation is a missed opportunity, and every physician wearing a lead apron for hours a day is paying a price they don’t have to pay.”
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