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System for Guidance during Interventional Procedure in the Vascular System

IP.com Disclosure Number: IPCOM000174716D
Original Publication Date: 2008-Oct-13
Included in the Prior Art Database: 2008-Oct-13
Document File: 3 page(s) / 40K

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Siemens

Related People

Juergen Carstens: CONTACT

Abstract

There are many technical solutions available that support clinical experts during interventional procedures treating diseases of the vascular system. Unfortunately, the systems are often not integrated. As a consequence, a physician needs to divide a considerable amount of his attention away from the patient on technical issues rather than concentrate on treating the disease at hand. This may result in a higher stress level for the physician and a suboptimal clinical outcome for the patient. Electrophysiology (EP) procedures are typical examples reflecting this dilemma. They involve cardiac catheter ablation and device implementation for cardiac resynchronization to treat patients with heart rhythm disorders. In addition, many systems may be used to during an electrophysiology (EP) case such as recording systems, mapping systems, ablator, and stimulator, 3D workstation.

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System for Guidance during Interventional Procedure in the Vascular System

Idea: Dr. Norbert Strobel, DE-Forchheim; Erik Busch, DE-Forchheim

There are many technical solutions available that support clinical experts during interventional procedures treating diseases of the vascular system. Unfortunately, the systems are often not integrated. As a consequence, a physician needs to divide a considerable amount of his attention away from the patient on technical issues rather than concentrate on treating the disease at hand. This may result in a higher stress level for the physician and a suboptimal clinical outcome for the patient.

Electrophysiology (EP) procedures are typical examples reflecting this dilemma. They involve cardiac catheter ablation and device implementation for cardiac resynchronization to treat patients with heart rhythm disorders. In addition, many systems may be used to during an electrophysiology (EP) case such as recording systems, mapping systems, ablator, and stimulator, 3D workstation.

The equipment used in a common electrophysiological laboratory usually includes a recording system that accommodates multiple intracardiac and body surface ECGs (Electro-CardioGrams). The signals are displayed on computer screens and stored. In addition, EP laboratories have a programmable impulse generator (stimulator), and a high-resolution fluoroscopy system. During a typical case, 2-5 electrode catheters are percutaneously inserted via the femoral or internal jugular veins and are positioned within the left heart, right heart, or both. Multiple catheters are needed to induce and map various tachyarrhythmias (fast heartbeats) prior to catheter ablation. A catheter in the coronary sinus is helpful to exclude left-sided accessory pathways or other left-sided tachyarrhythmias. The conventional, fluoroscopy-guided approach has some inherent limitations. First, fluoroscopy provides a two-dimensional anatomic view only, thereby limiting the ability to locate the catheter in three dimensions. Second, it is not possible to evaluate several potential sites of interest and memorize them to return back precisely to the most suitable site for ablation. Nonfluoroscopic mapping systems have been introduced to solve these problems.

The trend to introduce even more devices, e.g. for EP procedures in the interventional lab is ongoing. The current state-of-the art is that there are solutions to exchange information between the various systems via network transfer or storage media, e.g. from ablator to recording system or from imaging system to recording (such as patient information). More recently multimodal integration of 3D catheter mapping with 3D rendering of cardiac anatomy from multidetector computer tomography (MDCT) or magnetic resonance (MR) images has been implemented to navigate catheters into the true cardiac a...