Zero-fluoroscopy permanent pacemaker implantation using Ensite NavX system: Clinical viability or fanciful technique?

Autor:	Ping Guo, Chunxia Zhao, Guangzhi Chen, AL-Selmi Fadhle, Dao Wen Wang, Riccardo Proietti, Yan Wang, Jie Qiu
Rok vydání:	2018
Předmět:	Adult Male Pacemaker Artificial Heart.chambers 030204 cardiovascular system & hematology 030218 nuclear medicine & medical imaging Prosthesis Implantation 03 medical and health sciences Computer-Assisted 0302 clinical medicine 3d mapping Humans Medicine Fluoroscopy implantation Implantation procedure Cardiac device Aged medicine.diagnostic_test business.industry permanent pacemaker General Medicine Middle Aged Radiation Exposure Pacemaker Radiation exposure Treatment Outcome Surgery Computer-Assisted Artificial Surgery Female Permanent pacemaker Cardiology and Cardiovascular Medicine business Nuclear medicine Ensite NavX system zero-fluoroscopy
Zdroj:	Pacing and Clinical Electrophysiology. 41:122-127
ISSN:	0147-8389
DOI:	10.1111/pace.13248
Popis:	Background Fluoroscopy is the imaging modality routinely used for cardiac device implantation and electrophysiological procedures. Due to the rising concern regarding the harmful effects of radiation exposure to both the patients and operation staffs, novel 3D mapping systems have been developed and implemented in electrophysiological procedure for the navigation of catheters inside the heart chambers. Their applicability in cardiac device implantation has been rarely reported. Our aim is to evaluate the feasibility and safety of permanent pacemaker implantation without fluoroscopy. Methods and results From January 2012 to June 2016, six patients (50 ± 15 years, four of six were female, one of who was at the 25th week of gestation) who underwent permanent pacemaker implantation were included (zero-fluoroscopy group). Data from 20 consecutive cases of implantation performed under fluoroscopy guidance were chosen as a control group (fluoroscopy group). Total implantation procedure time for single-chamber pacemaker was 51.3 ± 13.1 minutes in the zero-fluoroscopy group and 42.6 ± 7.4 minutes in the fluoroscopy group (P = 0.155). The implantation procedural time for a dual-chamber pacemaker was 88.3 ± 19.6 minutes and 67.3 ± 7.6 minutes in the zero-fluoroscopy and fluoroscopy groups (P = 0.013), respectively. No complications were observed during the procedure and the follow-up in the two groups, and all pacemakers worked with satisfactory parameters. Conclusion Ensite NavX system can be used as a reliable and safe zero-fluoroscopy approach for the implantation of single- or dual-chamber permanent pacemakers in specific patients, such as pregnant women or in extreme situations when the x-ray machine is not available.
Databáze:	OpenAIRE
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