Dr. Clarence Khoo, Director of Arrhythmia Services in Cardiac Sciences at St. Boniface Hospital, with the Abbott ViewMate Ultrasound System that lets him see inside the chambers of the heart.
June 23, 2025
Seeing was believing for Dr. Clarence Khoo in 2024.
“It is an amazing machine. It really has changed the way that I, for one, have been able to do cases. Even just understanding what I’m doing has been phenomenal with it,” he said.
It is called an Abbott ViewMate Ultrasound System, and Khoo, the Director of Arrhythmia Services in Cardiac Sciences at St. B, says it’s “revolutionary” and “a game-changer.” Support from donors like you allowed the Hospital to put the new, state-of-the-art technology into wide use in 2024 .
What sets the ViewMate apart from other ultrasounds is the addition of an Intracardiac Echocardiography (ICE) probe. Clinicians like Khoo use ICE during ablation procedures in St. B’s Electrophysiology (EP) Lab to see moving images of a patient’s heart chambers from within.
An ablation treats an abnormal heart rhythm surgically by destroying, often by burning, precisely the small area of heart tissue that sends electrical signals from the atria to the ventricles.
“During an EP study, we can attach the ICE probe to a thin tube called a catheter. I insert it into a blood vessel, usually in the leg or groin, and guide it all the way up into the heart,” explained Khoo, sitting in his office at St. B.
“It was revolutionary to me…to see the difference it could make.”
Before ICE, Khoo’s only options were an ultrasound either from outside through the chest wall, or from the esophagus, which involves a probe down the throat, requiring sedation. Alternately, Khoo would use an X-ray that required him and other caregivers to wear heavy lead safety equipment.
“With ICE you can put the probe inside the heart, you can get really up close and personal. You can see things in detail that you wouldn’t otherwise be able to with standard ultrasound techniques,” said Khoo. “A lot of my generation were used to not having ICE. It was revolutionary for me, once I started to get comfortable with it, to see the difference it could make.”
ICE revealing what was previously unseen
More than anything, says Khoo, ICE takes the guesswork out of ablation surgery. He can see, in great detail, what was hidden before.
“With ICE there are things I can do now with more confidence than I could before,” he said.
“For the longest time, a lot of what we did in cardiology was not really knowing where we were. We ended up then using techniques like X-ray to guesstimate. Having the ability with ICE to really know where we are is exponentially safer and better than what we’ve done historically.”
Khoo describes the inside of a patient’s ventricle, in the lower chamber of the heart, as lumpy-bumpy on the inside. “There are lots of little hills and valleys,” he explained. “Historically, we would not be able to see those. You would just move your catheter around; let it fall where it would.”
“Having the ability with ICE to really know where we are is exponentially safer and better than what we’ve done historically.”
He gives an April 2025 ablation case as an example of ICE changing the game: “The arrhythmia itself was coming from a little strip of muscle that was hanging between two walls of the heart. We found that you had to burn right on that strip of tissue there to control the arrhythmia,” he said. “Without the ability to see with ICE, we would have been groping around in the dark. If you were lucky, you’d catch it, but I could not have known it was there without the ICE machine,” he continued.
“ICE benefits patients multifold. Better efficacy, better success rates. With ICE we are more likely now to know where to burn and what to burn; there’s less guesswork involved. The chance of having a successful ablation is much higher. Because we have a better understanding as to where we are, it makes for a safer procedure as well.”
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