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Figure 1 Intracardiac echocardiography images with the transducer (7.5 MHz) placed in the right atrium (RA) demonstrate spontaneous echo contrast, as slowly swirling amorphous echoes in a dilated (diameter = 5.2 cm) left atrium (LA) (left panel). Slowly swirling non-homogeneous echoes become more prominent during sheath flushing with heparinized solution (right panel).