Sensor‐Based Electromagnetic Navigation to Facilitate Implantation of Left Ventricular Leads in Cardiac Resynchronization Therapy

Abstract

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

Cardiac electrophysiology procedures guided by novel non-fluoroscopic catheter tracking systems

“…Interestingly, despite being a novel technology and skill-set, a non-significant trend toward shorter procedure duration was observed (120 vs. 138 minutes with non-MDG, P = 0.088). Similar results were noted in the series by Doring et al, where using a matched comparison with conventional CRT device implantations the authors demonstrated a significant reduction in fluoroscopy time (median 8.0 vs. 4.5 minutes; P = 0.016) and radiation dose (median 603-338 cGy.cm 2 , P = 0.044) [12].…”

Three‐Dimensional Electroanatomic Mapping System‐Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry

“…In the setting of device implantations, EAMS have been used to reduce radiation dose particularly in children and pregnant women . Recently, the first experiences of CRT devices implantation guided by EAMS have been published . The preliminary findings of these studies indicated that this approach significantly reduces radiation exposure and may even allow fluoroscopy to be completely avoided .…”

“…Median procedural time was 140 (122-180) minutes (average 158 minutes) and did not significantly differ compared with EAMS-guided procedures (P = 0.13). Coronary sinus angiography rate (83%) and median fluoroscopy time (median 16 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] minutes, average 20 minutes, mean DAP 88114 cGy*cm 2 ) were significantly higher than EAMS-guided procedures (P < 0.001 and P < 0.001, respectively). The LV lead was successfully implanted in 242 (97%) patients and complications were observed in 17 (7%) including CS dissection (N = 7), dislodgment of the atrial (N = 1) or LV lead (N = 4) requiring repositioning, pocket hematoma (N = 2), pocket infection (N = 1), and acute kidney failure (N = 2).…”

“…16 More recently, the use of EAMS has also been proposed for CRT device implantation, in order to reduce fluoroscopy time and the use of contrast dye and to provide useful information on CS electrical activation that can guide the placement of the LV lead. [17][18][19][20][21][22][23][24] To date, the experience with the EAMS-guided CRT implantation is limited and it is still unknown whether it may be feasible and advantageous also in less experienced centers.…”

Electroanatomic mapping‐guided localization of alternative right ventricular septal pacing sites in children

“…Currently, such EAMs are not routinely used during pacemaker implantation. However, some experiences with pacemakers and defibrillators in adults have been reported, in a grown‐up congenital heart defect (CHD) patient and in pediatric patients . In children with complete atrioventricular block (CAVB), the endocardial pacing site is often the right ventricular (RV) apex (RVA), although alternative RV sites (RVAPS) have been proposed to prevent or reduce RV pacing‐induced left ventricular (LV) dysfunction .…”