This paper presents a method for registering 3D intracardiac echo (ICE) to pre-operative images. A magnetic tracking sensor is integrated on the ICE catheter tip to provide the 3D location and orientation. The user guides the catheter into the patient heart to acquire a series of ultrasound images covering the anatomy of the heart chambers. An automatic intensity-based registration algorithm is applied to align these ultrasound images with pre-operative images. One of the important applications is to help electrophysiology doctors to treat complicated atrial fibrillation cases. After registration, the doctor can see the position and orientation of the ICE catheter and other tracked catheters inside the heart anatomy in real time. The image guidance provided by this technique may increase the ablation accuracy and reduce the amount of time for the electrophysiology procedures. We show successful image registration results from animal experiments.