Researchers use heart mapping system to guide pacemaker fitting

29th March 2016

A heart mapping system has been used to help doctors fit biventricular pacemakers without exposing them and their patients to x-ray radiation.

Traditionally doctors have used fluoroscopic guidance, an imaging technique that uses x-rays  to get real-time moving images of the heart’s structures, to help position the devices' leads in the heart.  But researchers have wanted to find methods to reduce the radiation this produces.

They have already found a way to fit single lead pacemakers using new technology, but now doctors in  Italy, led by Dr Andrea Collela, from Florence’s University Hospital Careggi, have used the St Jude mapping system to fit biventricular pacemakers (also called cardiac resynchronisation therapy or CRT), including ones also featuring an internal defibrillator (ICD). 

A total of  61 patients with heart failure were fitted with the pacemakers with or without fluoroscopic guidance. Of the 26 patients given the devices with the EnSite Velocity mapping system, 24 had the leads positioned successfully.

The researchers reported no complications during the procedure and no lead dislodgment one month afterwards.   The time taken for the fitting decreased from 136 minutes in the first case to 59 minutes in the last one, suggesting that surgeons gradually gained confidence using the new technique.

The researchers said:”Our study demonstrates the feasibility, efficacy and safety of lead positioning guided only by the non-fluoroscopic EnSite Velocity mapping system.”

The study has just been published in the Heart Rhythm Journal.

Ref: Zero x-ray cardiac resynchronisation therapy device implantation guided by a non-fluoroscopic mapping system: a pilot study.