3: March 2004
The University of Iowa Explores Opportunities with a New Technology: Paving a New Path for Heart Rhythm Management
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The University of Iowa Cardiology Department recently acquired the Stereotaxis Laboratory System, a magnetic guidance system which allows for precise navigation to hard-to-reach vessels and helps to treat rhythm problems in the chambers of the heart. In fact, they are only the eleventh in the world to have this technology. In this article, the authors also describe their experience and goals in using this system.
Matt Howard, Chairman of Neurosurgery at the University of Iowa, had a vision over a decade ago. He hoped to find new ways to move catheters inside blood vessels robotically. His hopes are now being realized after years of development. The concept was that manual manipulation of catheters inside blood vessels was possible, but an intricate network of non-linear three-dimensional anatomy could be too challenging to navigate.
Stump the Experts
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Last month, we included two mystery electrocardiograms for the first installment of this special monthly feature. Below we reveal the answers!
Description:
These recordings were obtained at the first clinic visit for this post-pacemaker- implant patient. The patient had been feeling increased fatigue in the last week.
Questions:
1. What is the rhythm?
2. What is occuring with the atrial electrogram?
Answers:
1. The rhythm is atrial flutter with variable A-V block. Cycle length of the atrial flutter is 320 ms. The cycle length is long because the
AEDs in the Community:EP Lab Digest Speaks with Dr. Winston Gandy
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In April of 2003, Atlanta s Hartsfield International Airport launched one of the nation s biggest automatic external defibrillator (AED) programs, Hartsfield Operation HartBeat. The program made national headlines as it quickly established the need for AEDs in densely populated public places, and rallied for community support and awareness education for sudden cardiac arrest. Then, almost three months after the HartBeat program went into effect, a traveler on an Atlantic Southeast Airlines flight collapsed after departing his plane on June 25. Thanks to the help from nearby passengers and the AED program, he was defibrillated before the paramedics even arrived. In this interview, EP Lab Digest speaks with Dr. Winston Gandy, Medical Director for Hartsfield.
How did the HartBeat program come about?
Management and Organization in Today's EP Lab
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The following accounts of staff management and organizational practices in the electrophysiology lab were taken from Spotlight Interviews published in EP Lab Digest in a 2-year period. The labs were all located in the United States, and were interviewed between September 2001 to September 2003. In this article, comments were edited slightly so as to focus solely on the management and organizational aspects of their labs, including data on the number of procedures performed by electrophysiologists, types of procedures, and mix of credentials at each EP lab. In reviewing over this information, perhaps you will find how your EP lab compares amongst these labs.
From 2001, Vol. 1, No. 1:
Email Discussion Group
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I cover EP studies in 15 hospitals across Louisiana and Mississippi. In all but one of these facilities, an RN is able to give sedation such as versed and fentanyl. However, one facility refuses to allow any EPs to be done without anesthesia support, even for versed and fentanyl. We are, of course, trying to change this. My question is for basic two to three catheter studies on adult patients. Does anyone require anesthesiology for versed and fentanyl as a standard protocol?
Anonymous, New Orleans, Louisiana
Conscious Sedation is the Norm
New technology, findings, uses
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Dear readers,
Looking to find out more about the ARVD Study, the Stereotaxis Laboratory System, or about integrating AEDs into the community? I am so happy to bring you all of this information (and more) in our March issue, just in time for the American College of Cardiology meeting.
In this issue, we also take a look at short QT syndrome (SQTS) in our second installment of the Sudden Death monthly section. Dr. Kathryn Glatter, who previously wrote on long QT syndrome, notes the characteristics of SQTS and writes that although the syndrome is rare, it may be a cause of SIDS.
March 2004
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Massachusetts General Hospital Installs AXIOM Artis dFC Magnetic Navigation System
System Assists Clinicians in Improving Ease and Accuracy of Catheter Procedures
Massachusetts General Hospital (MGH) is among the first in the country to offer digitally controlled catheter-based procedures, due to the recent installation of the AXIOM Artis dFC Magnetic Navigation System. The AXIOM Artis dFC Magnetic Navigation System was developed by Siemens Medical Solutions in conjunction with Stereotaxis, Inc.
The system is capable of helping electrophysiologists improve the ease and acc
ARVD Study Update: Interview with Frank Marcus, MD
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Dr. Marcus, from the University of Arizona Sarver Heart Center in Tucson, Arizona, and a founding member of its cardiology program, is Principal Investigator of the Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD) study. ARVD primarily affects the heart muscle in the right ventricle, causing potentially fatal ventricular arrhythmias. It accounts for a significant percentage of sudden death in athletes and young people, and is responsible for about 5% of unexplained cardiac deaths for those under the age of 65. The study is funded by a 5-year grant from The National Institutes of Health (NIH). There are 22 enrolling centers in the US and Canada.
How did you get involved in the field of EP?
Initial Experience with CryoCath Cryoablation at the Heart Hospital of New Mexico
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In the third installment of the Cryotherapy section, Dr. Constantin describes his experience using the CryoCath Freezor ablation system. In this article, he outlines the benefits of using cryoablation and compares its uses with radiofrequency.
One of the more compelling aspects of the field of clinical cardiac electrophysiology is the accelerated evolution of applied technologies impacting favorably on the lives of patients. A very recent addition hails from our neighbors in Canada. On April 22, CryoCath Technologies received FDA approval to market the Freezor ® Cryoablation System in the United States for the treatment of atrioventricular nodal reentry tachycardia (AVNRT). The first approved procedure was performed less than two weeks later at the Texas Heart Institute.
Tufts-New England Medical Center, Cardiac Arrhythmia Center
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Tufts-New England Medical Center (NEMC), located in Boston, Massachusetts, has long been considered one of the best in clinical care. Their electrophysiologists provide access to the newest advances in antiarrhythmic drugs, ICDs, pacemakers and ablation techniques through a wide range of therapeutic trials. The Cardiac Arrhythmia Center currently houses three EP labs; they are also building a fourth lab that is scheduled to be finished in May 2004. Keep reading to find out about the other innovations and projects going on at Tufts-NEMC.
What is the size of your EP lab facility and the number of staff members? What is the mix of credentials at your lab?
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