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The enthusiasm for novel, minimally invasive, catheter based intracardiac procedures has highlighted the need to provide accurate, realtime, anatomically based image guidance to decrease complications, improve precision, and decrease fluoroscopy time. The recent development of realtime 3D echocardiography creates the opportunity to greatly improve our ability to guide minimally invasive procedures (Ahmad, 2003). However, the need to present 3D data on a 2D display decreases the utility of 3D echocardiography because echocardiographers cannot readily appreciate 3D perspective on a 2D display without ongoing image manipulation. We evaluated the use of a novel strategy of presenting the data in a true 3D volumetric display, Perspecta Spatial 3D System (Actuality Systems, Inc., Burlington, MA). Two experienced echocardiographers performed the task of identifying the targeted location of a catheter within 6 different phantoms using four display methods. Echocardiographic images were obtained with a SONOS 7500 (Philips Medical Systems, Inc., Andover, MA). Completion of the task was significantly faster with the Perspecta display with no loss in accuracy. Echocardiography in 3D significantly improves the ability of echocardiography for guidance of catheter based procedures. Further improvement is achieved by using a true 3D volumetric display, which allows for more intuitive assessment of the spatial relationships of catheters in three-dimensional space compared with conventional 2D visualization modalities.