Dr John M

cardiac electrophysiologist, cyclist, learner

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GPS is not only for the iphone or dashboard…

May 8, 2010 By Dr John

To give credit when credit is due is right and just.

Medical industry absorbs, in both the mainstream media and the blogosphere, their fair share of body blows.  So here comes a glowing review of a new technology that has lived up to its hype.

Carto 3 is the next generation three-dimensional cardiac mapping system, from Biosense-Webster–a JNJ company.  Catheters within the beating heart can be visualized in real time.  Additionally, through some sort of engineering magic, way above my pay scale of understanding, roving catheters in a chamber of interest, create an anatomical shell, which is highly useful.

An amateurish, but real, 1.5 minute video shows the creation of the right upper pulmonary vein region of the left atrium. The green tip catheter is the ablation catheter.  I am moving it without stepping on the xray pedal.  The circular catheter is the multi-electrode catheter which is placed in the ostium of the vein.  Other areas of interest include the esophageal location sitting immediately posterior to the LA wall.  Also, at 7pm, the coronary sinus catheter is seen.

The radiation-badge-favorable 3D navigation system has even impressed the EP lab staff, who have been posting fluoroscopy times of both myself and another doctor, who is a friend, colleague, and non-dabbler in AF ablation on the white board.  In the past, we used to have to navigate the catheters with xray guidance, thus exposing the patient to significant radiation, but now we can navigate with both a fraction of the xray exposure, and far better precision.  This is really good stuff.

Lowering a patient’s radiation exposure is rightly in the news.  It is especially important in this era of expanding usage of radiation intensive procedures, like CT scans and nuclear imaging.

Recently, I had proudly accomplished an 11.2 minute xray time for a complete de novo AF ablation.  It had only been a few days when the familiar iphone txt message from my pal, Dr M, said 11.1 minutes.

AF ablation is still very serious.  It is not for the dabblers.  It is hard to learn and hard on the body.  So this 3D mapping, navigational and ablation system is indeed a welcome visitor.

No healthcare implications, just a solid note of thanks and congratulations.

JMM

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Related posts:

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  4. Atrial fibrillation ablation in the news. Some good science…

Filed Under: AF ablation, Atrial fibrillation Tagged With: Catheter ablation, iphone, Pulmonary Vein Isolation

John Mandrola, MD

Welcome, Enjoy, Interact. john-mandrola I am a cardiac electrophysiologist practicing in Louisville KY. I am also a husband to a palliative care doctor, a father, a bike racer, and a regular columnist at theHeart.org | Medscape

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  • Electrophysiology commentary on Medscape/Cardiology

Mandrola on Medscape

  • My Medscape column on general medical matters

For patients...Educational posts

  • 13 things to know about Atrial Fibrillation — 2014
  • A new cure of AF
  • Adding a new verb to doctoring: To deprescribe is to do a lot
  • AF ablation — 2015 A Cautionary Note
  • AF Ablation in 2012–An easier journey?
  • Atrial Flutter — 15 facts you may want to know.
  • Benign PVCs: A heart rhythm doctor’s approach.
  • Caution with early Cardioversion
  • Decisions of 2 low-risk cases of PAF
  • Defining success in AF ablation in 2014
  • Four commonly asked questions on AF ablation
  • Inflammation and AF — Get off the gas
  • Ten things to expect after AF ablation
  • The medical decsion as a gamble
  • The most important verb in our health crisis
  • Wellness Requires Ownership

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