INTRODUCTION:EnSite NavX (NavX) is a novel mapping and navigation system that allows visualization of conventional catheters for diagnostic and ablative purposes and uses them to create a three-dimensional (3D) geometry of the heart. NavX is particularly suitable for ablation procedures utilizing an anatomic approach, as in the setting of common-type atrial flutter (AFL). The aim of this study was to compare NavX-guided and conventional ablation procedures for AFL. METHODS AND RESULTS:Forty consecutive patients (32 male, 59 +/- 12 years) with documented AFL were randomized to undergo fluoroscopy-guided (group I, 20 patients) or NavX-guided (group II, 20 patients) ablation, including 3D isthmus reconstruction. The same catheter setup was used in both groups. The endpoint of bidirectional isthmus block was obtained in all patients. Compared to conventional approaches, NavX-guided procedures significantly reduced fluoroscopy time (5.1 +/- 1.4 min vs 20 +/- 11 min, P < 0.01) and total x-ray exposure (5.1 +/- 3.1 Gycm2 vs 24.9 +/- 1.6 Gycm2, P < 0.01). Isthmus geometry reconstruction could be performed in all patients of group II. In 4 patients (20%) of group II, anatomic isthmus variations were detected by NavX. No significant differences in radiofrequency current applications and procedural times were found between the two groups. CONCLUSION:NavX technology allows geometry reconstruction of the cavotricuspid isthmus. NavX-guided ablation of AFL reduces total x-ray exposure compared to the fluoroscopy-guided approach but does not prolong procedure time.
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INTRODUCTION: EnSite NavX (NavX) is a novel mapping and navigation system that allows visualization of conventional catheters for diagnostic and ablative purposes and uses them to create a three-dimensional (3D) geometry of the heart. NavX is particularly suitable for ablation procedures utilizing an anatomic approach, as in the setting of common-type atrial flutter (AFL). The aim of this study was to compare NavX-guided and conventional ablation procedures for AFL. METHODS AND RESULTS: Forty consecutive patients (32 male, 59 +/- 12 years) with documented AFL were randomized to undergo fluoroscopy-guided (group I, 20 patients) or NavX-guided (group II, 20 patients) ablation, including 3D isthmus reconstruction. The same catheter setup was used in both groups. The endpoint of bidirectional isthmus block was obtained in all patients. Compared to conventional approaches, NavX-guided procedures significantly reduced fluoroscopy time (5.1 +/- 1.4 min vs 20 +/- 11 min, P < 0.01) and total x-ray exposure (5.1 +/- 3.1 Gycm2 vs 24.9 +/- 1.6 Gycm2, P < 0.01). Isthmus geometry reconstruction could be performed in all patients of group II. In 4 patients (20%) of group II, anatomic isthmus variations were detected by NavX. No significant differences in radiofrequency current applications and procedural times were found between the two groups. CONCLUSION:NavX technology allows geometry reconstruction of the cavotricuspid isthmus. NavX-guided ablation of AFL reduces total x-ray exposure compared to the fluoroscopy-guided approach but does not prolong procedure time.
Authors: Douglas N Stephens; Uyen T Truong; Amin Nikoozadeh; Omer Oralkan; Chi Hyung Seo; Jonathan Cannata; Aaron Dentinger; Kai Thomenius; Alan de la Rama; Tho Nguyen; Feng Lin; Pierre Khuri-Yakub; Aman Mahajan; Kalyanam Shivkumar; Matt O'Donnell; David J Sahn Journal: J Ultrasound Med Date: 2012-02 Impact factor: 2.153
Authors: David J Sahn; Douglas N Stephens; Jonathan M Cannata; K Shung; Omer Oralkan; Amin Nikoozadeh; B T Pierre Khuri-Yakub; Hien Nguyen; Peter Chen; Aaron M Dentinger; Douglas Wildes; Kai E Thomenius; Aman Mahajan; Kalyanam Shivkumar; Matthew O'Donnell Journal: Conf Proc IEEE Eng Med Biol Soc Date: 2009
Authors: D N Stephens; J Cannata; Ruibin Liu; Jian Zhong Zhao; K K Shung; Hien Nguyen; R Chia; A Dentinger; D Wildes; K E Thomenius; A Mahajan; K Shivkumar; Kang Kim; M O'Donnell; A Nikoozadeh; O Oralkan; P T Khuri-Yakub; D J Sahn Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2008-07 Impact factor: 2.725
Authors: Amin Nikoozadeh; Ira O Wygant; Der-Song Lin; Omer Oralkan; A Sanli Ergun; Douglas N Stephens; Kai E Thomenius; Aaron M Dentinger; Douglas Wildes; Gina Akopyan; Kalyanam Shivkumar; Aman Mahajan; David J Sahn; Butrus T Khuri-Yakub Journal: IEEE Trans Ultrason Ferroelectr Freq Control Date: 2008-12 Impact factor: 2.725