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Catheter Placement and Model Reconstruction

  • Yan WangEmail author
Chapter

Abstract

Traditionally, fluoroscopy is widely used for guiding catheter movement during ablation procedures and make many patients free from severe arrhythmias. As we all know, radiation exposure is harmful to the patients. The medical staffs still receive cumulative radiation exposure despite wearing heavy-lead aprons for protection. Besides, the heavy-lead aprons exert heavy physical burden and thermal fatigue to the staffs. Recently, three-dimensional navigation system based on magnetic field or electric field is widely used in ablation procedures. Some operators begin to practice mapping and ablation under the guidance of three-dimensional navigation system with significantly reduced fluoroscopy or even without fluoroscopy. Among those three-dimensional navigation systems, Carto™ system utilizes magnetic field and electronic filed whereas EnSite™ system utilizes electronic filed for spatial navigation. Here we introduce the zero-fluoroscopic techniques for placing catheters, including right ventricle, high right atrium, His, and coronary sinus catheter, and the techniques for reconstructing models using the two kinds of navigation system.

Keywords

Catheter Catheterization Placement Insertion Model reconstruction Radiation Three-dimensional Navigation 

Abbreviations

AP

Anterior posterior

LAO

Left anterior oblique

PA

Posterior anterior

PVA

Pulmonary vein antrum

RAO

Right anterior oblique

RVOT

Right ventricular outflow tract

SVT

Supraventricular tachycardia

References

  1. 1.
    Calkins H, et al. Radiation exposure during radiofrequency catheter ablation of accessory atrioventricular connections. Circulation. 1991;84:2376–82.CrossRefGoogle Scholar
  2. 2.
    Wang Y, et al. Ablation of idiopathic ventricular arrhythmia using zero-fluoroscopy approach with equivalent efficacy and less fatigue: a multicenter comparative study. Medicine (Baltimore). 2017;96:e6080.  https://doi.org/10.1097/MD.0000000000006080.CrossRefGoogle Scholar
  3. 3.
    Ruiz-Granell R, et al. Implantation of single-lead atrioventricular permanent pacemakers guided by electroanatomic navigation without the use of fluoroscopy. Europace. 2008;10:1048–51.  https://doi.org/10.1093/europace/eun139eun139.CrossRefPubMedGoogle Scholar
  4. 4.
    Casella M, et al. “Near-zero” fluoroscopic exposure in supraventricular arrhythmia ablation using the EnSite NavX mapping system: personal experience and review of the literature. J Interv Card Electrophysiol. 2011;31:109–18.  https://doi.org/10.1007/s10840-011-9553-5.CrossRefPubMedGoogle Scholar
  5. 5.
    Gist K, Tigges C, Smith G, Clark J. Learning curve for zero-fluoroscopy catheter ablation of AVNRT: early versus late experience. Pacing Clin Electrophysiol. 2011;34:264–8.  https://doi.org/10.1111/j.1540-8159.2010.02952.x.CrossRefPubMedGoogle Scholar
  6. 6.
    Bulava A, Hanis J, Eisenberger M. Catheter ablation of atrial fibrillation using zero-fluoroscopy technique: a randomized trial. Pacing Clin Electrophysiol. 2015;38:797–806.  https://doi.org/10.1111/pace.12634.CrossRefPubMedGoogle Scholar
  7. 7.
    Scaglione M, et al. Zero-fluoroscopy ablation of accessory pathways in children and adolescents: CARTO3 electroanatomic mapping combined with RF and cryoenergy. Pacing Clin Electrophysiol. 2015;38:675–81.  https://doi.org/10.1111/pace.12619.CrossRefPubMedGoogle Scholar
  8. 8.
    Chen G, et al. Zero-fluoroscopy catheter ablation of severe drug-resistant arrhythmia guided by EnSite NavX system during pregnancy: two case reports and literature review. Medicine (Baltimore). 2016;95:e4487.  https://doi.org/10.1097/MD.0000000000004487.CrossRefGoogle Scholar
  9. 9.
    Gaita F, Guerra PG, Battaglia A, Anselmino M. The dream of near-zero X-rays ablation comes true. Eur Heart J. 2016;37:2749–55.  https://doi.org/10.1093/eurheartj/ehw223, pii: ehw223.CrossRefPubMedGoogle Scholar
  10. 10.
    Yang L, et al. Meta-analysis of zero or near-zero fluoroscopy use during ablation of cardiac arrhythmias. Am J Cardiol. 2016;118:1511–8.  https://doi.org/10.1016/j.amjcard.2016.08.014, pii: S0002-9149(16)31374-1.CrossRefPubMedGoogle Scholar
  11. 11.
    Fernandez-Gomez JM, et al. Exclusion of fluoroscopy use in catheter ablation procedures: six years of experience at a single center. J Cardiovasc Electrophysiol. 2014;25:638–44.  https://doi.org/10.1111/jce.12385.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Cardiovascular DivisionTongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyWuhanChina

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