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).
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- 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
Fernandez-Gomez JM, Morina-Vazquez P, Morales Edel R, Venegas-Gamero J, Barba-Pichardo R, Carranza MH. Exclusion of fluoroscopy use in catheter ablation procedures: six years of experience at a single center. J Cardiovasc Electrophysiol. 2014;25:638–44.
Chen G, Sun G, Xu R, Chen X, Yang L, Bai Y, Yang S, Guo P, Zhang Y, Zhao C, Wang DW, Wang Y. 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.
Yang L, Sun G, Chen X, Chen G, Yang S, Guo P, Wang Y, Wang DW. Meta-analysis of zero or near-zero fluoroscopy use during ablation of cardiac arrhythmias. Am J Cardiol. 2016;118:1511–8.
Lemery R. Interventional electrophysiology at the crossroads: cardiac mapping, ablation and pacing without fluoroscopy. J Cardiovasc Electrophysiol. 2012;23:1087–91.
Ventura R, Rostock T, Klemm HU, Lutomsky B, Demir C, Weiss C, Meinertz T, Willems S. Catheter ablation of common-type atrial flutter guided by three-dimensional right atrial geometry reconstruction and catheter tracking using cutaneous patches: a randomized prospective study. J Cardiovasc Electrophysiol. 2004;15:1157–61.
Wang Y, Chen GZ, Yao Y, Bai Y, Chu HM, Ma KZ, Liew R, Liu H, Zhong GQ, Xue YM, Wu SL, Li YF, Zhao CX, Liu QG, Lin L, Wang L, Wang DW. Ablation of idiopathic ventricular arrhythmia using zero-fluoroscopy approach with equivalent efficacy and less fatigue: a multicenter comparative study. Medicine (Baltimore). 2017;96:e6080.
Wittkampf FH, Wever EF, Derksen R, Wilde AA, Ramanna H, Hauer RN, Robles de Medina EO. Localisa: New technique for real-time 3-dimensional localization of regular intracardiac electrodes. Circulation. 1999;99:1312–7.
Merino JL, Peinado R, Silvestre J. Dual-chamber implantable cardioverter defibrillator implantation guided by non-fluoroscopic electro-anatomical navigation. Europace. 2008;10:1124–5.
Ruiz-Granell R, Ferrero A, Morell-Cabedo S, Martinez-Brotons A, Bertomeu V, Llacer A, Garcia-Civera R. Implantation of single-lead atrioventricular permanent pacemakers guided by electroanatomic navigation without the use of fluoroscopy. Europace. 2008;10:1048–51.
Ruiz-Granell R, Morell-Cabedo S, Ferrero-De-Loma A, Garcia-Civera R. Atrioventricular node ablation and permanent ventricular pacemaker implantation without fluoroscopy: use of an electroanatomic navigation system. J Cardiovasc Electrophysiol. 2005;16:793–5.
Tuzcu V, Kilinc OU. Implantable cardioverter defibrillator implantation without using fluoroscopy in a pregnant patient. Pacing Clin Electrophysiol. 2012;35:e265–6.
Guo P, Qiu J, Wang Y, Chen G, Proietti R, Fadhle AS, Zhao C, Wen Wang D. Zero-fluoroscopy permanent pacemaker implantation using ensite navx system: clinical viability or fanciful technique? Pacing Clin Electrophysiol. 2018;41:122–7.
Colella A, Giaccardi M, Colella T, Modesti PA. Zero x-ray cardiac resynchronization therapy device implantation guided by a nonfluoroscopic mapping system: a pilot study. Heart Rhythm. 2016;13(7):1481–8.
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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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