During the last two decades revolutionary diagnostic and therapeutic changes were implemented in the management of patients with arrhythmias. Since the arrhythmia substrate is frequently associated with certain anatomical structures or morphological variants, improved imaging has increasing role in the improvement of these treatments. Furthermore, novel catheter ablation approaches require catheter placement to sites, which may be associated with increased complication risk. Therefore imaging has a crucial role both in guiding and improving safety of electrophysiology procedures. Recently, intracardiac echocardiography became available providing excellent accuracy in direct visualization of anatomical landmarks. Intracardiac echocardiography is therefore a potentially useful tool for guiding electrophysiology procedures. The first two Hungarian cases with intracardiac echocardiography are presented with a broad background in this comprehensive review.