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Zero-Fluoroscopic Implantation of Cardiac Electronic Device

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Abstract

In the past decade, three-dimensional navigation systems, such as Ensite NavX (St. Jude Medical, St. Paul, MN, USA), CARTO (Biosense Webster, Diamond Bar, CA, USA), and LocaLisa (Medtronic, Minneapolis, MN, USA), have been developed and implemented in electrophysiological procedures; those systems are used to guide catheters inside the heart and can significantly reduce radiation exposure to patients and medical staffs (Fernandez-Gomez et al., J Cardiovasc Electrophysiol 25:638–644, 2014; Chen et al., Medicine (Baltimore) 95:e4487, 2016; Yang L et al., Am J Cardiol 118:1511–1518, 2016; Lemery, J Cardiovasc Electrophysiol 23:1087–1091, 2012; Ventura et al., J Cardiovasc Electrophysiol 15:1157–1561, 2004; Wang et al., Medicine (Baltimore) 96:e6080, 2017; Wittkampf et al. Circulation 99:1312–1317, 1999).

In this chapter, we introduce the techniques to perform zero- or near zero-fluoroscopic implantation of cardiac electronic device. As for the first implantation of single-chamber pacemaker, dual-chamber pacemaker, or implantable cardioverter defibrillator (ICD), almost all of the procedures can be performed without fluoroscopy, whereas a few cases may need very low dose of fluoroscopy, especially during the implantation of cardiac resynchronization therapy (CRT) (Merino JL et al., Europace 10:1124–1125, 2008; Ruiz-Granell R et al., Europace 10:1048–1051, 2008; Ruiz-Granell R et al., J Cardiovasc Electrophysiol 16:793–795, 2005; Tuzcu and Kilinc, Pacing Clin Electrophysiol 35:e265–e266, 2012; Guo et al., Pacing Clin Electrophysiol 41:122–127, 2018).

Keywords

  • Cardiac electronic device
  • Pacemaker
  • Implantable cardioverter defibrillator
  • Cardiac resynchronization therapy
  • Implantation
  • Fluoroscopy
  • Radiation
  • Three-dimensional
  • Navigation

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Abbreviations

CRT:

Cardiac resynchronization therapy

ICD:

Implantable cardioverter

LAO:

Left anterior oblique

RAO:

Right anterior oblique

In the past decade, three-dimensional navigation systems, such as Ensite NavX (St. Jude Medical, St. Paul, MN, USA), CARTO (Biosense Webster, Diamond Bar, CA, USA), and LocaLisa (Medtronic, Minneapolis, MN, USA), have been developed and implemented in electrophysiological procedures; those systems are used to guide catheters inside the heart and can significantly reduce radiation exposure to patients and medical staffs [1,2,3,4,5,6,7].

In this chapter, we introduce the techniques to perform zero- or near zero-fluoroscopic implantation of cardiac electronic device. As for the first implantation of single-chamber pacemaker, dual-chamber pacemaker, or implantable cardioverter defibrillator (ICD), almost all of the procedures can be performed without fluoroscopy, whereas a few cases may need very low dose of fluoroscopy, especially during the implantation of cardiac resynchronization therapy (CRT) [8,9,10,11,12].

References

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Wang, Y. (2019). Zero-Fluoroscopic Implantation of Cardiac Electronic Device. In: Proietti, R., Wang, Y., Yao, Y., Zhong, G., Lin Wu, S., Ayala-Paredes, F. (eds) Cardiac Electrophysiology Without Fluoroscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-16992-3_18

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  • DOI: https://doi.org/10.1007/978-3-030-16992-3_18

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