Ask an Expert

Please enter your login and password here

Send

Fellowship

Please enter your login and password here

Submit

Journal Scan

Sensor-based electromagnetic navigation to facilitate implantation of left ventricular leads in cardiacresynchronization therapy.


J Cardiovasc Electrophysiol. 2015 Feb;26(2):167-75.

Sensor-based electromagnetic navigation to facilitate implantation of left ventricular leads in cardiacresynchronization therapy.

Döring M1Sommer PRolf SLucas JBreithardt OAHindricks GRichter S.

 

INTRODUCTION:

Implantation of cardiac resynchronization therapy (CRT) devices can be challenging, time consuming, and fluoroscopy intense. Tofacilitate placement of left ventricular (LV) leads, a novel electromagnetic navigation system (MediGuide™, St. Jude Medical, St. Paul, MN, USA) has been developed, displaying real-time 3-D location of sensor-embedded delivery tools superimposed on prerecorded X-ray cine-loops of coronary sinus venograms. We report our experience and advanced progress in the use of this new electromagnetic tracking system to guide LV leadimplantation.

METHODS AND RESULTS:

Between January 2012 and December 2013, 71 consecutive patients (69 ± 9 years, 76% male) were implanted with a CRT device using the new electromagnetic tracking system. Demographics, procedural data, and periprocedural adverse events were gathered. The impact of the operator's experience, optimized workflow, and improved software technology on procedural data were analyzed. LV lead implantationwas successfully achieved in all patients without severe adverse events. Total procedure time measured 87 ± 37 minutes and the median total fluoroscopy time (skin-to-skin) was 4.9 (2.5-7.8) minutes with a median dose-area-product of 476 (260-1056) cGy*cm(2) . An additional comparison with conventional CRT device implantations showed a significant reduction in fluoroscopy time from 8.0 (5.8; 11.5) to 4.5 (2.8; 7.3) minutes (P = 0.016) and radiation dose from 603 (330; 969) to 338 (176; 680) cGy*cm(2) , respectively (P = 0.044 ).

CONCLUSION:

Use of the new navigation system enables safe and successful LV lead placement with improved orientation and significantly reduced radiation exposure during CRT implantation.

Videos

MEMBERSHIP CATEGORIES AND GUIDELINES

  • Members - Full time life members with voting rights: All those with DM/DNB cardiology qualification or equivalent and interest in arrhythmia/EP : Fees Rs 10,000.
  • Associate Members - DM/DNB/Fellows during training period. Fees Rs 3,000. No voting rights.
  • International Members: Overseas doctors with appropriate qualification and interest in arrhythmias. No voting rights. Fees 300$.
  • Industry members: Industry personnel associated with arrhythmology can become members. Membership is non-transferable. No voting rights. Fees 25,0000.
  • Any Associate Members who become eligible for Full time life membership (on completion of training period), need to pay only the balance of Rs 7,000 (10,000 - 3,000) if this is one within 1 year after completion of training. If the application for Full time life membership is received after expiry of one year of their entry as Associate Members, the full fees (viz Rs 10,000) shall apply.
  • Membership application need to be endorsed by two IHRS Members.
  • The application forms received by the office of Vice President, IHRS would need to be finally approved by the credentialing Committee (comprising of President, Secretary and Joint Secretary, IHRS).

Please print this form and send appropriate DD/Cheque in favour of Indian Heart Rhythm Society, and send through post to the following Address:

Dr Anil Saxena
Director, Cardiac Pacing & Electrophysiology
Fortis Escorts Heart Institute
Okhla Road, New Delhi, 110025 INDIA
Vice President, Indian Heart Rhythm Society
Mobile: +91 9810025511
Email: anil.saxena@hotmail.com
Secretary: +91 9910665566 (Ms Kumkum Sharma)