1
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Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, Usui A, Okishige K, Kusano K, Kumagai K, Goya M, Kobayashi Y, Shimizu A, Shimizu W, Shoda M, Sumitomo N, Seo Y, Takahashi A, Tada H, Naito S, Nakazato Y, Nishimura T, Nitta T, Niwano S, Hagiwara N, Murakawa Y, Yamane T, Aiba T, Inoue K, Iwasaki Y, Inden Y, Uno K, Ogano M, Kimura M, Sakamoto S, Sasaki S, Satomi K, Shiga T, Suzuki T, Sekiguchi Y, Soejima K, Takagi M, Chinushi M, Nishi N, Noda T, Hachiya H, Mitsuno M, Mitsuhashi T, Miyauchi Y, Miyazaki A, Morimoto T, Yamasaki H, Aizawa Y, Ohe T, Kimura T, Tanemoto K, Tsutsui H, Mitamura H. JCS/JHRS 2019 guideline on non-pharmacotherapy of cardiac arrhythmias. J Arrhythm 2021; 37:709-870. [PMID: 34386109 PMCID: PMC8339126 DOI: 10.1002/joa3.12491] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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2
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Nogami A, Kurita T, Abe H, Ando K, Ishikawa T, Imai K, Usui A, Okishige K, Kusano K, Kumagai K, Goya M, Kobayashi Y, Shimizu A, Shimizu W, Shoda M, Sumitomo N, Seo Y, Takahashi A, Tada H, Naito S, Nakazato Y, Nishimura T, Nitta T, Niwano S, Hagiwara N, Murakawa Y, Yamane T, Aiba T, Inoue K, Iwasaki Y, Inden Y, Uno K, Ogano M, Kimura M, Sakamoto SI, Sasaki S, Satomi K, Shiga T, Suzuki T, Sekiguchi Y, Soejima K, Takagi M, Chinushi M, Nishi N, Noda T, Hachiya H, Mitsuno M, Mitsuhashi T, Miyauchi Y, Miyazaki A, Morimoto T, Yamasaki H, Aizawa Y, Ohe T, Kimura T, Tanemoto K, Tsutsui H, Mitamura H. JCS/JHRS 2019 Guideline on Non-Pharmacotherapy of Cardiac Arrhythmias. Circ J 2021; 85:1104-1244. [PMID: 34078838 DOI: 10.1253/circj.cj-20-0637] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Akihiko Nogami
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Haruhiko Abe
- Department of Heart Rhythm Management, University of Occupational and Environmental Health, Japan
| | - Kenji Ando
- Department of Cardiology, Kokura Memorial Hospital
| | - Toshiyuki Ishikawa
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University
| | - Katsuhiko Imai
- Department of Cardiovascular Surgery, Kure Medical Center and Chugoku Cancer Center
| | - Akihiko Usui
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine
| | - Kaoru Okishige
- Department of Cardiology, Yokohama City Minato Red Cross Hospital
| | - Kengo Kusano
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | | | - Masahiko Goya
- Department of Cardiovascular Medicine, Tokyo Medical and Dental University
| | | | | | - Wataru Shimizu
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School
| | - Morio Shoda
- Department of Cardiology, Tokyo Women's Medical University
| | - Naokata Sumitomo
- Department of Pediatric Cardiology, Saitama Medical University International Medical Center
| | - Yoshihiro Seo
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | - Hiroshi Tada
- Department of Cardiovascular Medicine, Faculty of Medical Sciences, University of Fukui
| | | | - Yuji Nakazato
- Department of Cardiovascular Medicine, Juntendo University Urayasu Hospital
| | - Takashi Nishimura
- Department of Cardiac Surgery, Tokyo Metropolitan Geriatric Hospital
| | - Takashi Nitta
- Department of Cardiovascular Surgery, Nippon Medical School
| | - Shinichi Niwano
- Department of Cardiovascular Medicine, Kitasato University School of Medicine
| | | | - Yuji Murakawa
- Fourth Department of Internal Medicine, Teikyo University Hospital Mizonokuchi
| | - Teiichi Yamane
- Department of Cardiology, Jikei University School of Medicine
| | - Takeshi Aiba
- Division of Arrhythmia, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Koichi Inoue
- Division of Arrhythmia, Cardiovascular Center, Sakurabashi Watanabe Hospital
| | - Yuki Iwasaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Nippon Medical School
| | - Yasuya Inden
- Department of Cardiology, Nagoya University Graduate School of Medicine
| | - Kikuya Uno
- Arrhythmia Center, Chiba Nishi General Hospital
| | - Michio Ogano
- Department of Cardiovascular Medicine, Shizuoka Medical Center
| | - Masaomi Kimura
- Advanced Management of Cardiac Arrhythmias, Hirosaki University Graduate School of Medicine
| | | | - Shingo Sasaki
- Department of Cardiology and Nephrology, Hirosaki University Graduate School of Medicine
| | | | - Tsuyoshi Shiga
- Department of Cardiology, Tokyo Women's Medical University
| | - Tsugutoshi Suzuki
- Departments of Pediatric Electrophysiology, Osaka City General Hospital
| | - Yukio Sekiguchi
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | - Kyoko Soejima
- Arrhythmia Center, Second Department of Internal Medicine, Kyorin University Hospital
| | - Masahiko Takagi
- Division of Cardiac Arrhythmia, Department of Internal Medicine II, Kansai Medical University
| | - Masaomi Chinushi
- School of Health Sciences, Faculty of Medicine, Niigata University
| | - Nobuhiro Nishi
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
| | - Takashi Noda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center
| | - Hitoshi Hachiya
- Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital
| | | | | | - Yasushi Miyauchi
- Department of Cardiovascular Medicine, Nippon Medical School Chiba-Hokusoh Hospital
| | - Aya Miyazaki
- Department of Pediatric Cardiology, Congenital Heart Disease Center, Tenri Hospital
| | - Tomoshige Morimoto
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College
| | - Hiro Yamasaki
- Department of Cardiology, Faculty of Medicine, University of Tsukuba
| | | | | | - Takeshi Kimura
- Department of Cardiology, Graduate School of Medicine and Faculty of Medicine, Kyoto University
| | - Kazuo Tanemoto
- Department of Cardiovascular Surgery, Kawasaki Medical School
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3
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Bourier F, Vlachos K, Lam A, Martin CA, Takigawa M, Kitamura T, Massoullié G, Cheniti G, Frontera A, Duchateau J, Pambrun T, Klotz N, Derval N, Denis A, Hocini M, Haïssaguerre M, Cochet H, Jaïs P, Sacher F. Three-dimensional image integration guidance for cryoballoon pulmonary vein isolation procedures. J Cardiovasc Electrophysiol 2019; 30:2790-2796. [PMID: 31646698 DOI: 10.1111/jce.14249] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 09/25/2019] [Accepted: 10/17/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND We present a new, easily applicable approach for the guidance of cryoballoon (CB) pulmonary vein isolation (PVI) procedures that use the combination of a 3D-mapping system image integration module and computed tomographic (CT)-derived anatomy. The aim of this retrospective, nonrandomized study was to investigate: (a) an alternative use for an established radiofrequency image integration module for cryo procedures; (b) a guidance technology for cryo PVI based on integrated CT anatomy; and (c) its clinical impact. METHODS AND RESULTS CT left atrium-angiography was performed in 50 consecutive patients before a CB PVI procedure, and a 3D reconstruction of the cardiac anatomy was segmented. A total of 25 patients were treated using conventional fluoroscopy; 25 patients were treated using the 3D image integration technique. In the image integration group, the CARTO3 UNIVU (Biosense Webster) module was used for image integration of 3D anatomy and fluoroscopic imaging. Transseptal puncture and cryo PVI were guided by 3D-overlay imaging. Procedures were feasible without complications in all patients and cryo PVI procedures were successfully guided using the image integration technique. The intraprocedural time needed to perform image integration was 37 ± 10 seconds. Fluoroscopy time was 31.7 ± 11.7 minutes in the conventional group and 20.1 ± 7.9 minutes in the image integration group (P < .001), procedure time was 116.3 ± 29.0 minutes in the conventional group vs 101.2 ± 20.9 minutes in the 3D group (P = .04). CONCLUSION 3D-overlay guidance of CB PVI is feasible, safe, and applicable in real time with minimal effort. It may significantly reduce radiation exposure by introducing 3D information, known from electroanatomic mapping systems, into cryo PVI procedures.
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Affiliation(s)
- Felix Bourier
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Konstantinos Vlachos
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Anna Lam
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Claire A Martin
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Masateru Takigawa
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Takeshi Kitamura
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Grégoire Massoullié
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Ghassen Cheniti
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Antonio Frontera
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Josselin Duchateau
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Thomas Pambrun
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Nicolas Klotz
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Nicolas Derval
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Arnaud Denis
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Mélèze Hocini
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Michel Haïssaguerre
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Hubert Cochet
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Pierre Jaïs
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
| | - Frédéric Sacher
- Electrophysiology and Ablation Unit, Bordeaux University Hospital (CHU), Pessac-Bordeaux, France.,IHU Liryc, Electrophysiology and Heart Modeling Institute, Fondation Bordeaux Université, Pessac-Bordeaux, France.,Université de Bordeaux, INSERM U1045, Bordeaux, France
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4
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Ueda A, Soejima K, Miwa Y, Takeuchi S, Nagaoka M, Momose Y, Matsushita N, Hoshida K, Miyakoshi M, Togashi I, Maeda A, Hagiwara Y, Sato T, Yoshino H. Idiopathic Ventricular Arrhythmia Ablation Using Non-Fluoroscopic Catheter Visualization System. Int Heart J 2019; 60:78-85. [DOI: 10.1536/ihj.18-122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Akiko Ueda
- Division of Advanced Arrhythmia Management, Kyorin University Hospital
| | - Kyoko Soejima
- Department of Cardiology, Kyorin University Hospital
| | - Yosuke Miwa
- Department of Cardiology, Kyorin University Hospital
| | | | - Mika Nagaoka
- Department of Cardiology, Kyorin University Hospital
| | - Yuichi Momose
- Department of Cardiology, Kyorin University Hospital
| | | | - Kyoko Hoshida
- Department of Cardiology, Kyorin University Hospital
| | | | - Ikuko Togashi
- Department of Cardiology, Kyorin University Hospital
| | - Akiko Maeda
- Division of Advanced Arrhythmia Management, Kyorin University Hospital
| | - Yo Hagiwara
- Division of Engineering, Kyorin University Hospital
| | - Toshiaki Sato
- Division of Advanced Arrhythmia Management, Kyorin University Hospital
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5
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Kim J. Non-fluoroscopic Catheter Tracking System for Atrial Fibrillation Ablation. Korean Circ J 2018; 49:97-98. [PMID: 30468033 PMCID: PMC6331327 DOI: 10.4070/kcj.2018.0319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 09/27/2018] [Indexed: 12/20/2022] Open
Affiliation(s)
- Jun Kim
- Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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6
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First experience with zero-fluoroscopic ablation for supraventricular tachycardias using a novel impedance and magnetic-field-based mapping system. Clin Res Cardiol 2018; 107:578-585. [PMID: 29476203 PMCID: PMC6002461 DOI: 10.1007/s00392-018-1220-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 02/20/2018] [Indexed: 12/21/2022]
Abstract
AIMS Zero- and near-zero-fluoroscopic ablation techniques reduce the harmful effects of ionizing radiation during invasive electrophysiology procedures. We aimed to test the feasibility and safety of a zero-fluoroscopic strategy using a novel integrated magnetic and impedance-based electroanatomical mapping system for radiofrequency ablation (RFA) of supraventricular tachycardias (SVTs). METHODS We retrospectively studied 92 consecutive patients undergoing electrophysiology studies with/without RFA for supraventricular tachycardia (SVT) performed by a single operator at a single center. The first 42 (Group 1) underwent a conventional fluoroscopic-guided approach and the second 50 (Group 2) underwent a zero-fluoroscopic approach using the Ensite Precision™ 3-D magnetic and impedance-based mapping system (Abbott Inc). RESULTS Group 1 comprised 14 AV-nodal re-entrant tachycardia (AVNRT), 12 typical atrial flutter, 4 accessory pathway (AP), 2 atrial tachycardia (AT), and 9 diagnostic EP studies (EPS). Group 2 comprised 16 AVNRT, 17 atrial flutter, 6 AP, 3 AT, 2 AV-nodal ablations, and 7 EPS. A complete zero-fluoroscopic approach was achieved in 94% of Group 2 patients. All procedures were acutely successful, and no complications occurred. There was a significant reduction in fluoroscopy dose, dose area product, and time (p < 0.0001, for all), with no difference in procedure times. Ablation time for typical atrial flutter was shorter in Group 2 (p = 0.006). CONCLUSIONS A zero-fluoroscopic strategy for diagnosis and treatment of SVTs using this novel 3D-electroanatomical mapping system is feasible in majority of patients, is safe, reduces ionizing radiation exposure, and does not compromise procedural times, success rates, or complication rates.
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7
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Sommer P, Bertagnolli L, Kircher S, Arya A, Bollmann A, Richter S, Rolf S, Hindricks G. Safety profile of near-zero fluoroscopy atrial fibrillation ablation with non-fluoroscopic catheter visualization: experience from 1000 consecutive procedures. Europace 2018; 20:1952-1958. [DOI: 10.1093/europace/eux378] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/16/2017] [Indexed: 01/02/2023] Open
Affiliation(s)
- Philipp Sommer
- Department of Electrophysiology, Heart Center, University of Leipzig, Struempellstr. 39, Leipzig, Germany
- Leipzig Heart Institute (LHI), Trendelenburgstr. 16, Leipzig, Germany
| | - Livio Bertagnolli
- Department of Electrophysiology, Heart Center, University of Leipzig, Struempellstr. 39, Leipzig, Germany
| | - Simon Kircher
- Department of Electrophysiology, Heart Center, University of Leipzig, Struempellstr. 39, Leipzig, Germany
| | - Arash Arya
- Department of Electrophysiology, Heart Center, University of Leipzig, Struempellstr. 39, Leipzig, Germany
| | - Andreas Bollmann
- Department of Electrophysiology, Heart Center, University of Leipzig, Struempellstr. 39, Leipzig, Germany
| | - Sergio Richter
- Department of Electrophysiology, Heart Center, University of Leipzig, Struempellstr. 39, Leipzig, Germany
| | - Sascha Rolf
- Department of Cardiology, DRK Kliniken Berlin Westend, Spandauer Damm 130, Berlin, Germany
| | - Gerhard Hindricks
- Department of Electrophysiology, Heart Center, University of Leipzig, Struempellstr. 39, Leipzig, Germany
- Leipzig Heart Institute (LHI), Trendelenburgstr. 16, Leipzig, Germany
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8
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Thibault B, Macle L, Mondésert B, Dubuc M, Shohoudi A, Dyrda K, Guerra PG, Rivard L, Roy D, Talajic M, Khairy P. Reducing radiation exposure during procedures performed in the electrophysiology laboratory. J Cardiovasc Electrophysiol 2017; 29:308-315. [PMID: 29064134 DOI: 10.1111/jce.13373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 09/22/2017] [Accepted: 10/16/2017] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Expert societies recently published strong recommendations to reduce the exposure of patients and staff to ionizing radiation (IR) during interventional and electrophysiology (EP) procedures. However, adherence to these guidelines remains difficult and the impact of implementing such recommendations is poorly characterized. METHODS AND RESULTS We conducted a single-center cohort study to quantify radiation exposure over time in three EP laboratories at the Montreal Heart Institute during 5,546 consecutive procedures from 2012 to 2015 by 11 primary operators. Overall, 2,618 (47.2%) procedures were catheter-based and 2,928 (52.8%) were device interventions. Interventions to reduce radiation exposure included educational initiatives to raise awareness (i.e., limiting cine acquisition, patient position, table height), slower frame rate, lower radiation dose per pulse, collimation, and integration with 3-D mapping systems and/or MediGuide technology. An 85% reduction in IR exposure was observed from 2012 to 2015, with the mean dose-area-product (DAP) decreasing from 7.65 ± 0.05 Gy·cm2 to 1.15 ± 0.04 Gy·cm2 (P < 0.001). This was true for catheter-based procedures (mean DAP 16.99 ± 0.08 to 2.00 ± 0.06 Gy·cm2 , P < 0.001) and device interventions (mean DAP 4.18 ± 0.06 to 0.64 ± 0.05 Gy·cm2 , P < 0.001). The median effective dose of IR recorded per quarter by 282 cervical dosimeters on EP staff decreased from 0.57 (IQR 0.18, 1.03) mSv in 2012 to 0.00 (IQR 0.00, 0.19) mSv in 2015, P < 0.001. CONCLUSION Enforcing good clinical practices with simple measures and low-dose fluoroscopy settings are highly effective in reducing IR exposure in the EP lab. These promising results should encourage other EP labs to adopt similar protective measures.
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Affiliation(s)
- Bernard Thibault
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Laurent Macle
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Blandine Mondésert
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Marc Dubuc
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Azadeh Shohoudi
- Montreal Health Innovations Coordinating Center, Montreal Heart Innovations Coordinating Center, Montrel Heart Institute, Université de Montréal, Montréal, Canada
| | - Katia Dyrda
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Peter G Guerra
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Léna Rivard
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Denis Roy
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Mario Talajic
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
| | - Paul Khairy
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine, Université de Montréal, Montréal, Canada
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9
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BALLESTEROS GABRIEL, RAMOS ARDANAZ PABLO, NEGLIA RENZO, PALACIO SOLÍS MARCEL, DÍAZ FERNÁNDEZ CRISTINA, LÓPEZ GONZÁLEZ GRACIELA, JANIASHVILI ELENE, GARCÍA-BOLAO IGNACIO. Mediguide-Assisted Transseptal Puncture without Echocardiographic Guidance. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:545-550. [DOI: 10.1111/pace.13039] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - RENZO NEGLIA
- Cardiology Department; Clínica Universidad de Navarra; Pamplona Spain
| | | | | | | | - ELENE JANIASHVILI
- Cardiology Department; Clínica Universidad de Navarra; Pamplona Spain
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10
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THIBAULT BERNARD, MONDÉSERT BLANDINE, MACLE LAURENT, DUBUC MARC, DYRDA KATIA, TALAJIC MARIO, ROY DENIS, RIVARD LÉNA, GUERRA PETERG, ANDRADE JASONG, KHAIRY PAUL. Reducing Radiation Exposure During CRT Implant Procedures: Single-Center Experience With Low-Dose Fluoroscopy Settings and a Sensor-Based Navigation System (MediGuide). J Cardiovasc Electrophysiol 2016; 27:1337-1343. [DOI: 10.1111/jce.13048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/30/2016] [Accepted: 07/12/2016] [Indexed: 12/27/2022]
Affiliation(s)
- BERNARD THIBAULT
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - BLANDINE MONDÉSERT
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - LAURENT MACLE
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - MARC DUBUC
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - KATIA DYRDA
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - MARIO TALAJIC
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - DENIS ROY
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - LÉNA RIVARD
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - PETER G. GUERRA
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - JASON G. ANDRADE
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
| | - PAUL KHAIRY
- Electrophysiology Service, Montreal Heart Institute and the Department of Medicine; Université de Montréal; Montreal Quebec Canada
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Electromagnetic navigation versus fluoroscopy in aortic endovascular procedures: a phantom study. Int J Comput Assist Radiol Surg 2016; 12:51-57. [DOI: 10.1007/s11548-016-1466-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 07/26/2016] [Indexed: 11/25/2022]
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12
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Gaita F, Guerra PG, Battaglia A, Anselmino M. The dream of near-zero X-rays ablation comes true. Eur Heart J 2016; 37:2749-2755. [DOI: 10.1093/eurheartj/ehw223] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/12/2016] [Indexed: 11/15/2022] Open
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Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, Estes NM, Field ME, Goldberger ZD, Hammill SC, Indik JH, Lindsay BD, Olshansky B, Russo AM, Shen WK, Tracy CM, Al-Khatib SM. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia. Circulation 2016; 133:e506-74. [DOI: 10.1161/cir.0000000000000311] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | - Hugh Calkins
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Jamie B. Conti
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Barbara J. Deal
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - N.A. Mark Estes
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Michael E. Field
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Zachary D. Goldberger
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Stephen C. Hammill
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Julia H. Indik
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Bruce D. Lindsay
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Brian Olshansky
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Andrea M. Russo
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Win-Kuang Shen
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Cynthia M. Tracy
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information. HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
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Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, Estes NM, Field ME, Goldberger ZD, Hammill SC, Indik JH, Lindsay BD, Olshansky B, Russo AM, Shen WK, Tracy CM, Al-Khatib SM. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary. Circulation 2016; 133:e471-505. [DOI: 10.1161/cir.0000000000000310] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
| | | | | | - Hugh Calkins
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Jamie B. Conti
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Barbara J. Deal
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - N.A. Mark Estes
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Michael E. Field
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Zachary D. Goldberger
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Stephen C. Hammill
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Julia H. Indik
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Bruce D. Lindsay
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Brian Olshansky
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Andrea M. Russo
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Win-Kuang Shen
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
| | - Cynthia M. Tracy
- Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry and other entities may apply; see Appendix 1 for recusal information.HRS Representative. ACC/AHA Representative. ACC/AHA Task Force on Performance Measures Liaison. ACC/AHA Task Force on Clinical Practice Guidelines Liaison. Former Task Force member; current member during this writing effort
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2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary. J Am Coll Cardiol 2016; 67:1575-1623. [DOI: 10.1016/j.jacc.2015.09.019] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, Estes III NM, Field ME, Goldberger ZD, Hammill SC, Indik JH, Lindsay BD, Olshansky B, Russo AM, Shen WK, Tracy CM, Al-Khatib SM. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia. Heart Rhythm 2016; 13:e136-221. [DOI: 10.1016/j.hrthm.2015.09.019] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Indexed: 01/27/2023]
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Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, Estes NAM, Field ME, Goldberger ZD, Hammill SC, Indik JH, Lindsay BD, Olshansky B, Russo AM, Shen WK, Tracy CM, Al-Khatib SM. 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: Executive summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Heart Rhythm 2015; 13:e92-135. [PMID: 26409097 DOI: 10.1016/j.hrthm.2015.09.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Indexed: 10/23/2022]
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Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, Estes NAM, Field ME, Goldberger ZD, Hammill SC, Indik JH, Lindsay BD, Olshansky B, Russo AM, Shen WK, Tracy CM, Al-Khatib SM. 2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2015; 67:e27-e115. [PMID: 26409259 DOI: 10.1016/j.jacc.2015.08.856] [Citation(s) in RCA: 239] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Sommer P, Kircher S, Rolf S, Richter S, Doering M, Arya A, Bollmann A, Hindricks G. Non-fluoroscopic catheter tracking for fluoroscopy reduction in interventional electrophysiology. J Vis Exp 2015:e52606. [PMID: 26066541 PMCID: PMC4542975 DOI: 10.3791/52606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A technological platform (MediGuide) has been recently introduced for non-fluoroscopic catheter tracking. In several studies, we have demonstrated that the application of this non-fluoroscopic catheter visualization system (NFCV) reduces fluoroscopy time and dose by 90-95% in a variety of electrophysiology (EP) procedures. This can be of relevance not only to the patients, but also to the nurses and physicians working in the EP lab. Furthermore, in a subset of indications such as supraventricular tachycardias, NFCV enables a fully non-fluoroscopic procedure and allows the lab staff to work without wearing lead aprons. With this protocol, we demonstrate that even complex procedures such as ablations of atrial fibrillation, that are typically associated with fluoroscopy times of >30 min in conventional settings, can safely be performed with a reduction of >90% in fluoroscopy exposure by the additional use of NFCV.
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Affiliation(s)
- Philipp Sommer
- Department of Electrophysiology, Heart Center, University of Leipzig;
| | - Simon Kircher
- Department of Electrophysiology, Heart Center, University of Leipzig
| | - Sascha Rolf
- Department of Electrophysiology, Heart Center, University of Leipzig
| | - Sergio Richter
- Department of Electrophysiology, Heart Center, University of Leipzig
| | - Micha Doering
- Department of Electrophysiology, Heart Center, University of Leipzig
| | - Arash Arya
- Department of Electrophysiology, Heart Center, University of Leipzig
| | - Andreas Bollmann
- Department of Electrophysiology, Heart Center, University of Leipzig
| | - Gerhard Hindricks
- Department of Electrophysiology, Heart Center, University of Leipzig
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Akbulak RÖ, Schäffer B, Jularic M, Moser J, Schreiber D, Salzbrunn T, Meyer C, Eickholt C, Kuklik P, Hoffmann BA, Willems S. Reduction of Radiation Exposure in Atrial Fibrillation Ablation Using a New Image Integration Module: A Prospective Randomized Trial in Patients Undergoing Pulmonary Vein Isolation. J Cardiovasc Electrophysiol 2015; 26:747-53. [PMID: 25807878 DOI: 10.1111/jce.12673] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Revised: 02/23/2015] [Accepted: 03/17/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Recently, a new image integration module (IIM, CartoUnivu™ Module) has been introduced to combine and merge fluoroscopy images with 3-dimensional-(3D)-electroanatomical maps (Carto® 3 System) into an accurate 3D view. The aim of the study was to investigate the influence of IIM on the fluoroscopy exposure during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) in a prospective randomized trial. METHODS AND RESULTS Between June and November 2014, a total of 60 patients with PAF (73.3% male, 64.0 ± 9.2 years), who underwent PVI with the endpoint of unexcitability of the ablation line, were randomized to either a conventional 3D mapping system (Carto® 3 System) or to an additional IIM on the basis of an assumed reduction of fluoroscopy exposure by the use of IIM. There were no significant differences in baseline characteristics. The median ablation procedure time was identical in both groups (140.7 ± 27.8 minutes vs. 140.8 ± 39.5 minutes; P = 0.851). A significant decrease of mean fluoroscopy time from 11.9 ± 2.1 to 7.4 ± 2.6 minutes (P < 0.0006) and median fluoroscopy dose from 882.9 to 476.5 cGycm(2) (P < 0.001) was achieved. The main reduction of radiation could be realized during creation of the 3D-map. No major complications occurred during the procedures. After a median follow-up of 125.7 ± 45.6 days 80% of the patients were free from any atrial arrhythmias. CONCLUSION CartoUnivu™ module easily integrates into the workflow of PVI with the endpoint of unexcitability of the ablation line without prolonging the procedure time. It is associated with a marked reduction in fluoroscopic dose when compared to a conventional 3D mapping system.
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Affiliation(s)
- Ruken Özge Akbulak
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Benjamin Schäffer
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Mario Jularic
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Moser
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Doreen Schreiber
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Tim Salzbrunn
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Meyer
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Eickholt
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Pawel Kuklik
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Boris A Hoffmann
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Stephan Willems
- Department of Cardiology - Electrophysiology, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
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Mansour M, Afzal MR, Gunda S, Pillarisetti J, Heist K, Acha MR, Heard M, Ruskin J, Lakkireddy D. Feasibility of Transseptal Puncture Using a Nonfluoroscopic Catheter Tracking System. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2015; 38:791-6. [PMID: 25712806 DOI: 10.1111/pace.12617] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 02/12/2015] [Accepted: 02/16/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Radiation exposure in the electrophysiology lab is a major occupational hazard to the electrophysiologists. A catheter localization system (MediGuide Technology, St. Jude Medical Inc., St. Paul, MN, USA) allows the integration of electroanatomical mapping and x-ray imaging, and has been shown to be effective in reducing radiation exposure during several electrophysiological procedures. We intended to evaluate the feasibility of this catheter tracking system to guide transseptal (TS) access. METHODS The feasibility of performing TS puncture with MediGuide (MDG) was assessed in a prospective observational study in 16 patients undergoing radiofrequency ablation for atrial fibrillation. These patients were compared to 16 matched patients undergoing similar procedures during the same time frame using conventional approach. There were no differences in mean age, gender distribution, and body mass index between the two groups. Total duration of fluoroscopic exposure during TS puncture was compared between the two groups. RESULTS All patients underwent successful TS puncture. Fluoroscopy time for double TS puncture using the MDG system was significantly lower than the control group (0.48 ± 0.17 minutes vs. 5.9 ± 0.65 minutes; P < 0.0001). No major complications occurred during the procedures in either group. CONCLUSIONS TS puncture can be successfully performed using MDG, and results in significant reduction in radiation exposure.
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Affiliation(s)
- Moussa Mansour
- Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Muhammad R Afzal
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, Kansas
| | - Sampath Gunda
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, Kansas
| | - Jayasree Pillarisetti
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, Kansas
| | - Kevin Heist
- Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Moshe Rav Acha
- Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | | | - Jeremy Ruskin
- Cardiac Arrhythmia Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dhanunjaya Lakkireddy
- Division of Cardiovascular Diseases, Cardiovascular Research Institute, University of Kansas Hospital & Medical Center, Kansas City, Kansas
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MALLIET NICOLAS, ANDRADE JASONG, KHAIRY PAUL, NGUYEN THANH HIENKIEM, VENIER SANDRINE, DUBUC MARC, DYRDA KATIA, GUERRA PETER, MONDÉSERT BLANDINE, RIVARD LÉNA, TADROS RAFIK, TALAJIC MARIO, THIBAULT BERNARD, ROY DENIS, MACLE LAURENT. Impact of a Novel Catheter Tracking System on Radiation Exposure during the Procedural Phases of Atrial Fibrillation and Flutter Ablation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2015; 38:784-90. [DOI: 10.1111/pace.12611] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 01/27/2015] [Accepted: 02/09/2015] [Indexed: 11/30/2022]
Affiliation(s)
- NICOLAS MALLIET
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - JASON G. ANDRADE
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
- Department of Medicine; The University of British Columbia; Vancouver Canada
| | - PAUL KHAIRY
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - HIEN KIEM NGUYEN THANH
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - SANDRINE VENIER
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - MARC DUBUC
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - KATIA DYRDA
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - PETER GUERRA
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - BLANDINE MONDÉSERT
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - LÉNA RIVARD
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - RAFIK TADROS
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - MARIO TALAJIC
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - BERNARD THIBAULT
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - DENIS ROY
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
| | - LAURENT MACLE
- Electrophysiology Service; Montreal Heart Institute; Montreal Canada
- Department of Medicine; Université de Montréal; Montreal Canada
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Schoene K, Rolf S, Schloma D, John S, Arya A, Dinov B, Richter S, Bollmann A, Hindricks G, Sommer P. Ablation of typical atrial flutter using a non-fluoroscopic catheter tracking system vs. conventional fluoroscopy--results from a prospective randomized study. Europace 2015; 17:1117-21. [PMID: 25736724 DOI: 10.1093/europace/euu398] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/15/2014] [Indexed: 11/12/2022] Open
Abstract
AIMS Reduction of radiation exposure using a sensor-based non-fluoroscopic catheter tracking (NFCT) system (MediGuide™, St Jude Medical, Inc.) was recently demonstrated by retrospective comparisons. We aimed to prospectively compare the effects of using NFCT vs. standard fluoroscopy on procedural parameters in patients undergoing radiofrequency ablation of typical atrial flutter. METHODS AND RESULTS We prospectively randomized 40 patients undergoing cavotricuspid isthmus ablation for typical atrial flutter to either NFCT (n = 20) or conventional fluoroscopy (CONV, n = 20). Procedural parameters such as fluoroscopy time, radiation dose, and procedure duration, as well as periprocedural complications were compared. There were no statistically significant differences in baseline characteristics between the two groups. Bidirectional isthmus block was achieved in all patients. Fluoroscopy time was significantly reduced in the NFCT group {0.3 [inter-quartile range (IQR) 0.2; 0.48] min} when compared with CONV [5.7 (IQR 4.2; 11.5) min] (P < 0.001). This resulted in a significant reduction in radiation dose in patients randomized to NFCT [17.4 (IQR 11; 206.6) cGy cm(2)] vs. the CONV group [418.4 (IQR 277; 812.2) cGy cm(2)] (P < 0.001). There were no significant differences in procedure duration between the NFCT group [49.5 (IQR 37; 65) min] when compared with the CONV group [33.5 (IQR 26.3; 55.5) min] (P = 0.053). No adverse events were recorded. Freedom from atrial flutter at 6 months of follow-up was 19/20 (95%) in the NFCT and 18/20 (90%) in the CONV group (n.s.). CONCLUSION In this first prospective randomized study, by comparing NFCT with standard fluoroscopy in patients undergoing radiofrequency ablation of typical atrial flutter, NFCT significantly reduced both radiation dose and fluoroscopy time with no effects on procedural duration. These findings support the incorporation of NFCT in routine clinical use.
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Affiliation(s)
- Katharina Schoene
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Sascha Rolf
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Denis Schloma
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Silke John
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Arash Arya
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Borislav Dinov
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Sergio Richter
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Andreas Bollmann
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Gerhard Hindricks
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
| | - Philipp Sommer
- Heart Center, Department of Electrophysiology, University of Leipzig, Struempellstrasse 39, Leipzig 04289, Germany
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Sommer P, Rolf S, Piorkowski C, Gaspar T, Huo Y, Piedra C, Richter S, Bollmann A, Arya A, Hindricks G. Nonfluoroscopic Catheter Visualization in Atrial Fibrillation Ablation. Circ Arrhythm Electrophysiol 2014; 7:869-74. [DOI: 10.1161/circep.114.001542] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Philipp Sommer
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Sascha Rolf
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Christopher Piorkowski
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Thomas Gaspar
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Yan Huo
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Carlos Piedra
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Sergio Richter
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Andreas Bollmann
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Arash Arya
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
| | - Gerhard Hindricks
- From the Heart Center, Department of Electrophysiology, University of Leipzig, Leipzig, Germany (P.S., S. Rolf, C. Piedra, S. Richter, A.B., A.A., G.H.); and Heart Center, University of Dresden, Dresden, Germany (C. Piorkowski, T.G., Y.H.)
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Pillarisetti J, Kanmanthareddy A, Reddy YM, Lakkireddy D. MediGuide-impact on catheter ablation techniques and workflow. J Interv Card Electrophysiol 2014; 40:221-7. [PMID: 24928484 DOI: 10.1007/s10840-014-9909-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 04/24/2014] [Indexed: 10/25/2022]
Abstract
Since the introduction of percutaneous intervention in modern medical science, specifically cardiovascular medicine fluoroscopy has remained the gold standard for navigation inside the cardiac structures. As the complexity of the procedures continue to increase with advances in interventional electrophysiology, the procedural times and fluoroscopy times have proportionately increased and the risks of radiation exposure both to the patients as well as the operator continue to rise. 3D electroanatomic mapping systems have to some extent complemented fluoroscopic imaging in improving catheter navigation and forming a solid platform for exploring the electroanatomic details of the target substrate. The 3D mapping systems are still limited as they continue to be static representations of a dynamic heart without being completely integrated with fluoroscopy. The field needed a technological solution that could add a dynamic positioning system that can be successfully incorporated into fluoroscopic imaging as well as electroanatomic imaging modalities. MediGuide is one such innovative technology that exploits the geo-positioning system principles. It employs a transmitter mounted on the X-ray panel that emits an electromagnetic field within which sensor-equipped diagnostic and ablation catheters are tracked within prerecorded fluoroscopic images. MediGuide is also integrated with NavX mapping system and helps in developing better 3D images by field scaling-a process that reduces field distortions that occur from impedance mapping alone. In this review, we discuss about the principle of MediGuide technology, the catheter ablation techniques, and the workflow in the EP lab for different procedures.
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26
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Muser D, Magnani S, Santangeli P. Ablation of typical atrial flutter using the novel MediGuide 3D catheter tracking system: a review of the literature. Expert Rev Cardiovasc Ther 2014; 12:799-802. [DOI: 10.1586/14779072.2014.925801] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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27
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Pappone C, Berto MB, Santinelli V. The Unique MediGuide Technology For CRT Lead Placement And Catheter Ablation. J Atr Fibrillation 2014; 7:1072. [PMID: 27957083 PMCID: PMC5135152 DOI: 10.4022/jafib.1072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 06/10/2014] [Accepted: 06/09/2014] [Indexed: 11/10/2022]
Abstract
Electrophysiologic procedures such as catheter ablation and/or cardiac resynchronization therapy (CRT) are usually performed under fluoroscopic guidance alone. Currently, we are witnessing the birth of a new era in which many patients can be safely and effectively treated without the use of fluoroscopy. Using MediGuide technology continuous fluoroscopy is no longer required to ascertain the position of the device/catheter, which minimizes the radiation exposure for both the physician and patient, with a further benefit by minimal need for contrast agent. This novel system provides real time tracking of devices projected into live fluoroscopy or pre-recorded cine-angiography. MediGuide technology is an important step forward facilitating complex ablation procedures such as AF ablation and CRT implantation.
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Affiliation(s)
- Carlo Pappone
- Department of Arrhythmology, Maria Cecilia Hospital, GVM Care and Research, Cotignola; Italy
| | - Martina Boscolo Berto
- Department of Arrhythmology, Maria Cecilia Hospital, GVM Care and Research, Cotignola; Italy
| | - Vincenzo Santinelli
- Department of Arrhythmology, Maria Cecilia Hospital, GVM Care and Research, Cotignola; Italy
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28
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Kircher S, Rolf S, Hindricks G, Sommer P. Ablation of typical atrial flutter using a novel non-fluoroscopic electromagnetic catheter tracking system. Interv Cardiol 2014. [DOI: 10.2217/ica.14.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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29
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MACÍAS ROSA, URIBE INÉS, TERCEDOR LUIS, JIMÉNEZ-JÁIMEZ JUAN, BARRIO TERESA, ÁLVAREZ MIGUEL. A Zero-Fluoroscopy Approach to Cavotricuspid Isthmus Catheter Ablation: Comparative Analysis of Two Electroanatomical Mapping Systems. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2014; 37:1029-37. [DOI: 10.1111/pace.12376] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 01/21/2014] [Accepted: 02/05/2014] [Indexed: 12/22/2022]
Affiliation(s)
- ROSA MACÍAS
- Unidad de Arritmias; Hospital Universitario Virgen de las Nieves; Granada Spain
| | - INÉS URIBE
- Unidad de Arritmias; Hospital Universitario Virgen de las Nieves; Granada Spain
| | - LUIS TERCEDOR
- Unidad de Arritmias; Hospital Universitario Virgen de las Nieves; Granada Spain
| | - JUAN JIMÉNEZ-JÁIMEZ
- Unidad de Arritmias; Hospital Universitario Virgen de las Nieves; Granada Spain
| | - TERESA BARRIO
- Unidad de Arritmias; Hospital Universitario Virgen de las Nieves; Granada Spain
| | - MIGUEL ÁLVAREZ
- Unidad de Arritmias; Hospital Universitario Virgen de las Nieves; Granada Spain
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30
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Non-fluoroscopic catheter visualization using MediGuide™ technology: experience from the first 600 procedures. J Interv Card Electrophysiol 2014; 40:209-14. [DOI: 10.1007/s10840-013-9859-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 10/24/2013] [Indexed: 10/25/2022]
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31
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VALDERRABANO MIGUEL, GREENBERG STEVEN, RAZAVI HEDI, MORE ROHAN, RYU KYUNGMOO, HEIST EKEVIN. 3D Cardiovascular Navigation System: Accuracy and Reduction in Radiation Exposure in Left Ventricular Lead Implant. J Cardiovasc Electrophysiol 2013; 25:87-93. [DOI: 10.1111/jce.12290] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 07/09/2013] [Accepted: 08/02/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | | | | | - E. KEVIN HEIST
- Massachusetts General Hospital; Boston Massachusetts USA
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32
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Vallakati A, Reddy YM, Emert M, Janga P, Mansour MC, Heist EK, Pimentel R, Dendi R, Atkins D, Bommana S, Mahapatra S, Heard M, Ruskin J, Berenbom L, Dawn B, Lakkireddy D. Impact of nonfluoroscopic MediGuide™ tracking system on radiation exposure in radiofrequency ablation procedures (LESS-RADS registry)—an initial experience. J Interv Card Electrophysiol 2013; 38:95-100. [DOI: 10.1007/s10840-013-9825-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 08/06/2013] [Indexed: 11/30/2022]
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33
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Rolf S, John S, Gaspar T, Dinov B, Kircher S, Huo Y, Bollmann A, Richter S, Arya A, Hindricks G, Piorkowski C, Sommer P. Catheter ablation of atrial fibrillation supported by novel nonfluoroscopic 4D navigation technology. Heart Rhythm 2013; 10:1293-300. [DOI: 10.1016/j.hrthm.2013.05.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Indexed: 10/26/2022]
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34
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Yamabe H. Utility of novel nonfluoroscopic 4D navigation technology for catheter ablation. Heart Rhythm 2013; 10:1301-2. [PMID: 23707393 DOI: 10.1016/j.hrthm.2013.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Indexed: 11/26/2022]
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35
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Sommer P, Piorkowski C, Gaspar T, Eitel C, Derndorfer M, Martinek M, Pürerfellner H, Arya A, Hindricks G, Rolf S. MediGuide in supraventricular tachycardia: initial experience from a multicentre registry. ACTA ACUST UNITED AC 2013; 15:1292-7. [DOI: 10.1093/europace/eut090] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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36
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Pillai A, Reddy M, Heard M, Vallakati A, Berenbom L, Lakkireddy D. Atrial Flutter Ablation Using MediGuide TM Non-fluoroscopic Catheter Tracking System: A Novel Technology to Reduce Radiation Exposure. J Atr Fibrillation 2012; 5:730. [PMID: 28496782 DOI: 10.4022/jafib.730] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Revised: 10/06/2012] [Accepted: 10/06/2012] [Indexed: 11/10/2022]
Abstract
We describe the first case of cardiac arrhythmia ablation with the novel MediGuideTM non-fluoroscopic catheter tracking system in North America. This new technology uses electromagnetic field to track sensor integrated intracardiac electrophysiology catheters which are projected on pre-recorded fluoroscopy cine loops. This new technology permits catheter tracking in virtual biplane fluoroscopy and enhances spatial resolution of conventional 3D mapping systems while drastically reducing radiation exposure.
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Affiliation(s)
- Anand Pillai
- Section of Electrophysiology, Bloch Heart Rhythm Center, University of Kansas Hospital, Kansas City, KS
| | - Madhu Reddy
- Section of Electrophysiology, Bloch Heart Rhythm Center, University of Kansas Hospital, Kansas City, KS
| | | | - Ajay Vallakati
- Section of Electrophysiology, Bloch Heart Rhythm Center, University of Kansas Hospital, Kansas City, KS
| | - Loren Berenbom
- Section of Electrophysiology, Bloch Heart Rhythm Center, University of Kansas Hospital, Kansas City, KS
| | - Dhanunjaya Lakkireddy
- Section of Electrophysiology, Bloch Heart Rhythm Center, University of Kansas Hospital, Kansas City, KS
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37
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Boveda S, Combes N, Marijon E. Imagine ... imaging. Europace 2012; 15:476-7. [PMID: 23027844 DOI: 10.1093/europace/eus322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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