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Philipp Sommer, Livio Bertagnolli, Simon Kircher, Arash Arya, Andreas Bollmann, Sergio Richter, Sascha Rolf, Gerhard Hindricks
Aims: Efforts to reduce radiation exposure during catheter ablation procedures have included the use of various technological measures. Significant results have been achieved to the point where near lead-free procedures in routine clinical practice has become a realistic goal. The integration of MediGuide technology [non-fluoroscopic catheter visualization technology (NFCV)] and three-dimensional electroanatomical mapping is one of the methods developed in response to radiation reduction initiatives...
January 16, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Bernard Thibault, Laurent Macle, Blandine Mondésert, Marc Dubuc, Azadeh Shohoudi, Katia Dyrda, Peter G Guerra, Léna Rivard, Denis Roy, Mario Talajic, Paul Khairy
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...
October 24, 2017: Journal of Cardiovascular Electrophysiology
Gabriel Ballesteros, Pablo Ramos Ardanaz, Renzo Neglia, Marcel Palacio Solís, Cristina Díaz Fernández, Graciela López González, Elene Janiashvili, Ignacio García-Bolao
BACKGROUND: First description of a technique for left atrium transseptal puncture (TSP) with minimal radiation exposure by using the nonfluoroscopic MediGuide™ tracking system (MG; St. Jude Medical, St. Paul, MN, USA) without the assistance of intracardiac echocardiography. METHODS: This study included 31 consecutive patients with atrial fibrillation undergoing an MG-assisted percutaneous catheter ablation procedure. A Brockenbrough transseptal needle (BRK) is connected to a standard pressure transducer through a two-input valve...
May 2017: Pacing and Clinical Electrophysiology: PACE
Christopher Piorkowski, Ole-A Breithardt, Hedi Razavi, Yelena Nabutovsky, Stuart P Rosenberg, Craig D Markovitz, Arash Arya, Sascha Rolf, Silke John, Jedrzej Kosiuk, Eric Olson, Charlotte Eitel, Yan Huo, Michael Döring, Sergio Richter, Kyungmoo Ryu, Thomas Gaspar, Frits W Prinzen, Gerhard Hindricks, Philipp Sommer
Aims: In times of evolving cardiac resynchronization therapy, intra-procedural characterization of left ventricular (LV) mechanical activation patterns is desired but technically challenging with currently available technologies. In patients with normal systolic function, we evaluated the feasibility of characterizing LV wall motion using a novel sensor-based, real-time tracking technology. Methods and results: Ten patients underwent simultaneous motion and electrical mapping of the LV endocardium during sinus rhythm using electroanatomical mapping and navigational systems (EnSite™ NavX™ and MediGuide™, SJM)...
October 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Bernard Thibault, Blandine Mondésert, Laurent Macle, Marc Dubuc, Katia Dyrda, Mario Talajic, Denis Roy, Léna Rivard, Peter G Guerra, Jason G Andrade, Paul Khairy
INTRODUCTION: Cardiac resynchronization therapy (CRT) implant procedures are often complex and prolonged, resulting in substantial ionizing radiation (IR) exposure to the patient and operator. We assessed the impact of lower-dose fluoroscopy settings and a sensor-based electromagnetic tracking system (Mediguide™, MDG) on reducing IR exposure during CRT implantation. METHODS: A single-center two-group cohort study was conducted on 348 consecutive patients, age 66...
July 26, 2016: Journal of Cardiovascular Electrophysiology
Bernard Thibault, Kyungmoo Ryu, Amit Cohen, Peter G Guerra
We report a case in which a novel three-dimensional (3D) electromagnetic cardiovascular navigation system (MediGude™, St. Jude Medical, St. Paul, MN, USA) was used to create a 3D reconstruction of the axillary vein and its anatomic course to guide its successful puncture and cannulation. The MediGuide system's projection accuracy has proved to offer a level of precision that is sufficient to achieve axillary vein access. This highlights its enormous possibilities to obtain 3D venous system reconstruction with minimal fluoroscopic use when performing cardiac or even non-cardiac procedures...
May 30, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Laurent Macle, Bernard Thibault, Jason G Andrade
No abstract text is available yet for this article.
2016: Expert Review of Medical Devices
Felix Bourier, Tilko Reents, Sonia Ammar-Busch, Alessandra Buiatti, Christian Grebmer, Marta Telishevska, Amir Brkic, Verena Semmler, Carsten Lennerz, Bernhard Kaess, Marc Kottmaier, Christof Kolb, Isabel Deisenhofer, Gabriele Hessling
BACKGROUND: Data about localization reproducibility as well as spatial and visual accuracy of the new MediGuide® sensor-based electroanatomic navigation technology are scarce. We therefore sought to quantify these parameters based on phantom experiments. METHODS AND RESULTS: A realistic heart phantom was generated in a 3D-Printer. A CT scan was performed on the phantom. The phantom itself served as ground-truth reference to ensure exact and reproducible catheter placement...
October 2015: Journal of Cardiovascular Electrophysiology
Philipp Sommer, Simon Kircher, Sascha Rolf, Sergio Richter, Micha Doering, Arash Arya, Andreas Bollmann, Gerhard Hindricks
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...
2015: Journal of Visualized Experiments: JoVE
Moussa Mansour, Muhammad R Afzal, Sampath Gunda, Jayasree Pillarisetti, Kevin Heist, Moshe Rav Acha, Michael Heard, Jeremy Ruskin, Dhanunjaya Lakkireddy
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...
July 2015: Pacing and Clinical Electrophysiology: PACE
Bernard Thibault, Jason G Andrade, Marc Dubuc, Mario Talajic, Peter G Guerra, Katia Dyrda, Laurent Macle, Léna Rivard, Denis Roy, Blandine Mondésert, Paul Khairy
BACKGROUND: Cardiac resynchronization therapy (CRT) implant procedures are often complex and prolonged, resulting in significant ionizing radiation (IR) exposure to the patient and operator. We report our early experience working with a novel sensor-based electromagnetic tracking system (MediGuide™, MDG, St. Jude Medical Inc., St. Paul, MN, USA), in terms of procedural IR exposure reduction. METHODS AND RESULTS: Information regarding patient demographics, procedural details, procedural duration, and IR exposure were prospectively collected on 130 consecutive CRT procedures performed between January 2013 and January 2014...
January 2015: Pacing and Clinical Electrophysiology: PACE
Michael Döring, Philipp Sommer, Sascha Rolf, Johannes Lucas, Ole A Breithardt, Gerhard Hindricks, Sergio Richter
INTRODUCTION: Implantation of cardiac resynchronization therapy (CRT) devices can be challenging, time consuming, and fluoroscopy intense. To facilitate 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 lead implantation...
February 2015: Journal of Cardiovascular Electrophysiology
Philipp Sommer, Sascha Rolf, Christopher Piorkowski, Thomas Gaspar, Yan Huo, Carlos Piedra, Sergio Richter, Andreas Bollmann, Arash Arya, Gerhard Hindricks
BACKGROUND: A technological platform (MediGuide) has been recently introduced for nonfluoroscopic catheter tracking. No data on the safety of this technology are yet available in a large cohort of patients. METHODS AND RESULTS: Data from a prospective ablation registry were analyzed. All patients undergoing atrial fibrillation ablation procedures supported by nonfluoroscopic catheter visualization technology were included. Patient characteristics and procedural data and complications within the first 3 months were recorded...
October 2014: Circulation. Arrhythmia and Electrophysiology
Jayasree Pillarisetti, Arun Kanmanthareddy, Yeruva Madhu Reddy, Dhanunjaya Lakkireddy
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...
September 2014: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Daniele Muser, Silvia Magnani, Pasquale Santangeli
The MediGuide™ system is a novel technology for non-fluoroscopic 3D catheter tracking during cardiovascular electrophysiological procedures. The system allows for precise catheter visualization on pre-recorded conventional fluoroscopy images, with significant reduction of fluoroscopy exposure. This might translate into improved safety for both patients and operators, without affecting the procedural efficacy. Preliminary data suggest that the MediGuide technology is at least as safe and effective as conventional systems for mapping and catheter ablation of a variety of supraventricular arrhythmias, with a significantly reduced fluoroscopy exposure...
July 2014: Expert Review of Cardiovascular Therapy
P Sommer, S Richter, G Hindricks, S Rolf
A novel cardiovascular navigation system known as MediGuide™ (MG) which allows non-fluoroscopic catheter tracking over a background of pre-recorded cine loops was recently introduced. This system allows significant reduction of fluoroscopy exposure which is one of the potentially harmful aspects of today's electrophysiological procedures such as ablations or device implantations. We provide a summary of recently published studies related to this new technological platform and describe our experience from the first 600 MG procedures at our institution...
September 2014: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Miguel Valderrabano, Steven Greenberg, Hedi Razavi, Rohan More, Kyungmoo Ryu, E Kevin Heist
INTRODUCTION: Cardiac resynchronization therapy implants entail significant radiation exposure for patients and physicians. A novel 3D electromagnetic cardiovascular navigation system (MediGuide™) was designed to superimpose the real-time location of sensors embedded in delivery tools on prerecorded coronary sinus (CS) venograms while adjusting for patient movement and variations in heart rate under different C-arm angulations. We studied the accuracy and efficacy of MediGuide™ in reducing radiation exposure during LV lead implants...
January 2014: Journal of Cardiovascular Electrophysiology
Ajay Vallakati, Yeruva Madhu Reddy, Martin Emert, Pramod Janga, Moussa C Mansour, E Kevin Heist, Rhea Pimentel, Raghuveer Dendi, Donita Atkins, Sudharani Bommana, Srijoy Mahapatra, Michael Heard, Jeremy Ruskin, Loren Berenbom, Buddhadeb Dawn, Dhanunjaya Lakkireddy
BACKGROUND: Radiation exposure in the electrophysiology (EP) lab is a major concern to most electrophysiologists. A new technology, MediGuide™ nonfluoroscopic catheter tracking system, has been used for the first time in the USA recently. We intended to evaluate the efficacy of this novel catheter tracking system in reducing radiation exposure. METHODS: We performed a prospective observational study by comparing the radiation exposure with MediGuide™ system to that of conventional mapping systems...
November 2013: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Sergio Richter, Michael Döring, Thomas Gaspar, Silke John, Sascha Rolf, Philipp Sommer, Gerhard Hindricks, Christopher Piorkowski
BACKGROUND: Cardiac resynchronization therapy (CRT) device implantation can be challenging, time consuming, and fluoroscopy intense. To facilitate left ventricular lead placement, a novel sensor-based electromagnetic tracking system (MediGuide Technology [MGT], St. Jude Medical) has been developed. We report the results of the First Human Use study evaluating the feasibility, safety, and performance of a novel CRT implantation approach using electromagnetic trackable operation equipment...
October 2013: Circulation. Arrhythmia and Electrophysiology
Sascha Rolf, Silke John, Thomas Gaspar, Boris Dinov, Simon Kircher, Yan Huo, Andreas Bollmann, Sergio Richter, Arash Arya, Gerhard Hindricks, Christopher Piorkowski, Philipp Sommer
BACKGROUND: The MediGuide technology (MGT) represents a novel sensor-based electromagnetic 4-dimensional (4D) navigation system allowing real-time catheter tracking in the environment of prerecorded X-ray loops. OBJECTIVE: To report on our clinical experience in atrial fibrillation (AF) ablation with recently available MGT-enabled ablation catheters. METHODS: The MGT was used in addition to a conventional 3D mapping system in 80 patients with AF (age 61 ± 10 years; 47 men; 40 with persistent AF), who underwent circumferential pulmonary vein isolation and voltage mapping with and without substrate modification...
September 2013: Heart Rhythm: the Official Journal of the Heart Rhythm Society
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