10/27/2013

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More Understanding Better Management

Dr. Mohamed Magdy MD

Use of the CARTO systems has been shown to reduce fluoroscopic exposure and radiation dose. Among the data provided by EAM are chamber reconstruction, tagging of important anatomic landmarks and ablation lesions, display of diagnostic and mapping catheters without using fluoroscopy, activation mapping, and voltage (or scar) mapping.

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CartoSound® Module with SoundStar® Catheter Carto® 3 MEM Software CartoUnivu™ Module VisiTag™ Module Paso™ Module nMARQ

Tools for understanding

CARTO Sound The CartoSound® Module with SoundStar® Catheter helps to easily identify specific cardiac anatomy and the exact location of the ablation catheter during AF* procedures in real-time. The integration of ultrasound with Carto® System technology streamlines procedural efficiency, contributes to safety, and enhances the clarity of anatomical images

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The new Carto® 3 MEM Software allows you to acquire multiple mapping points simultaneously with a high level of detail. Combined with MEM-enabled catheters, it helps accelerate high resolution mapping.

The new CartoUnivu™ Module seamlessly combines a fluoro image and Carto® 3 System maps into a single view. It helps reduce fluoroscopy levels to as low as reasonably achievable and helps minimize exposure for physicians, staff, and patients.

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The new VisiTag™ Module provides greater visibility for RF ablation strategy. It displays parameters of lesion formation that can be used prospectively or retrospectively. And it allows to objectively index ablation parameters to help facilitate consistency and continuity.

The new Paso™ Module delivers automated template matching for targeting complex ventricular tachycardia procedures. It automatically compares pace mapping signals with arrhythmia signals to better inform your VT ablation strategy.

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The nMARQ™ Multi-Ablation Technology delivers speed and fine-tuned performance with every ablation.

Ablate with any or all of the 7-10 catheter electrodes by simply pressing a button. That is efficiency to the nth power.

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Management

More understanding is the way to success

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Storm at the UAE

61 year old male

HTN, Dyslipidemic, smoker, obese

MI 2009, EF 35 %

Underwent CRTD implantation 2010

Presented to us with storm, 20 shocks, sustained ventricular tachycardia, new ECHO EF 15 %

Patient data

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Clinical VT

Most probably coming from LV, outflow tract, (RtBBB,inf leads +ve, early transV2)

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Scar at post part of LVOT Dense at endocardial surface (red zone), less dense at Epicardial surface(bipolar/unipolar)

Clinical VT, Pace mapping 12/12= exit site

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Ablation at lower part of LVOT, termination of tachycardia (creating a line from zone of scare to Mitral valve) anatomical barrier ablation targeted late potentials (entrance site), and also ablation at exit with best pace map 12/12