35 Electrophysiology and electrostimulation: experience

Abstract In the last 50 years, cardiac electrophysiology has undergone rapid technological development which has led to a numerical increase in both patients who have been able to benefit from the therapies of rediscovery and rhythm control, and of the devices. The activity of an electrophysiology and electrostimulation room is based on the intensive use of ionizing radiation even if electrophysiology studies, ablation, and cryoablation techniques have benefited from the support of computerized electroanatomical mapping systems with consequent dose reduction. Over the years, the instruments to be managed inside the room have increased both in complexity and numerically. Starting from the biventricular PM, we go through the implantation of subcutaneous defibrillators up to the transseptal ablations. Patient management requires additional skills that each member of the team must possess. Continuous training and updates are of fundamental importance. The purpose of this work is our experience based on the activity now more 10 years.

Download Full-text

Electroanatomical Mapping Systems. An Epochal Change in Cardiac Electrophysiology

Medical Imaging in Clinical Applications - Studies in Computational Intelligence ◽

10.1007/978-3-319-33793-7_11 ◽

2016 ◽

pp. 237-255

Author(s):

Carlo Pappone ◽

Carmine Garzillo ◽

Simonetta Crisà ◽

Vincenzo Santinelli

Keyword(s):

Cardiac Electrophysiology ◽

Electroanatomical Mapping ◽

Epochal Change ◽

Mapping Systems

Download Full-text

Into a Fluoroless Future: an Appraisal of Fluoroscopy-Free Techniques in Clinical Cardiac Electrophysiology

Current Cardiology Reports ◽

10.1007/s11886-021-01461-y ◽

2021 ◽

Vol 23 (4) ◽

Author(s):

Christopher S. Purtell ◽

Ryan T. Kipp ◽

Lee L. Eckhardt

Keyword(s):

Cardiac Electrophysiology ◽

Imaging Technique ◽

Early Experience ◽

Intracardiac Echocardiography ◽

Electroanatomic Mapping ◽

Supporting Evidence ◽

Device Implantation ◽

Mri Guidance ◽

Fluoroscopic Imaging ◽

Mapping Systems

Abstract Purpose of Review There are risks to both patients and electrophysiology providers from radiation exposure from fluoroscopic imaging, and there is increased interest in fluoroscopic reduction. We review the imaging tools, their applications, and current uses to eliminate fluoroscopy. Recent Findings Multiple recent studies provide supporting evidence for the transition to fluoroscopy-free techniques for both ablations and device implantation. The most frequently used alternative imaging approaches include intracardiac echocardiography, cardiac MRI guidance, and 3D electroanatomic mapping systems. Electroanatomic mapping and intracardiac echocardiography originally used to augment fluoroscopy imaging are now replacing the older imaging technique. The data supports that the future of electrophysiology can be fluoroscopy-free or very low fluoroscopy for the vast majority of cases. Summary As provider and institution experience grows with these techniques, many EP labs may choose to completely forego the use of fluoroscopy. Trainees will benefit from early experience with these techniques.

Download Full-text

Exploring Factors Influencing Big Data and Analytics Adoption in Healthcare Management

Handbook of Research on Managing Information Systems in Developing Economies - Advances in Information Quality and Management ◽

10.4018/978-1-7998-2610-1.ch020 ◽

2020 ◽

pp. 413-428

Author(s):

Sampson Abeeku Edu ◽

Divine Q. Agozie

Keyword(s):

Big Data ◽

Data Management ◽

Patient Management ◽

Technological Development ◽

Healthcare Management ◽

Quality Cost ◽

Healthcare Data ◽

Management Quality ◽

Factors Influencing ◽

Quality Decision

Demand for improvement in healthcare management in the areas of quality, cost, and patient care has been on the upsurge because of technology. Incessant application and new technological development to manage healthcare data significantly led to leveraging on the use of big data and analytics (BDA). The application of the capabilities from BDA has provided healthcare institutions with the ability to make critical and timely decisions for patients and data management. Adopting BDA by healthcare institutions hinges on some factors necessitating its application. This study aims to identify and review what influences healthcare institutions towards the use of business intelligence and analytics. With the use of a systematic review of 25 articles, the study identified nine dominant factors driving healthcare institutions to BDA adoption. Factors such as patient management, quality decision making, disease management, data management, and promoting healthcare efficiencies were among the highly ranked factors influencing BDA adoption.

Download Full-text

Management of pulmonary hypertension: basic treatment

ESC CardioMed ◽

10.1093/med/9780198784906.003.0585 ◽

2018 ◽

pp. 2511-2514

Author(s):

Stephan Rosenkranz

Keyword(s):

Physical Activity ◽

Risk Assessment ◽

Birth Control ◽

Patient Management ◽

Psychosocial Support ◽

Elective Surgery ◽

Rhythm Control ◽

Response To Treatment ◽

Pulmonary Arterial ◽

Basic Treatment

The management of patients with pulmonary arterial hypertension (PAH) comprises a complex strategy that includes targeted PAH therapies, but also basic treatment of the disease. This chapter focuses on the latter, which may be subdivided into general measures (physical activity/supervised rehabilitation, pregnancy, birth control/postmenopausal hormonal therapy, elective surgery, infection prevention, psychosocial support, genetic counselling, and travel), and supportive care (anticoagulation, diuretics, oxygen, cardiovascular drugs, iron deficiency, and rhythm control). These additional treatments are an integral part of patient management which help to improve morbidity and mortality in patients with PAH. Treatment decisions are based on the initial evaluation of severity and risk assessment, the presence of co-morbidities, the response to treatment, and the course of the disease.

Download Full-text

Contemporary Mapping Techniques of Complex Cardiac Arrhythmias — Identifying and Modifying the Arrhythmogenic Substrate

Arrhythmia & Electrophysiology Review ◽

10.15420/aer.2015.4.1.19 ◽

2015 ◽

Vol 4 (1) ◽

pp. 19 ◽

Cited By ~ 22

Author(s):

Emmanuel Koutalas ◽

Sascha Rolf ◽

Borislav Dinov ◽

Sergio Richter ◽

Arash Arya ◽

...

Keyword(s):

Cardiac Arrhythmias ◽

Cardiac Electrophysiology ◽

Ventricular Tachycardia Ablation ◽

Substrate Modification ◽

Improved Outcomes ◽

Arrhythmogenic Substrate ◽

Reasonable Cost ◽

Conventional Mapping ◽

Mapping Techniques ◽

Mapping Systems

Cardiac electrophysiology has moved a long way forward during recent decades in the comprehension and treatment of complex cardiac arrhythmias. Contemporary electroanatomical mapping systems, along with state-of-the-art technology in the manufacture of electrophysiology catheters and cardiac imaging modalities, have significantly enriched our armamentarium, enabling the implementation of various mapping strategies and techniques in electrophysiology procedures. Beyond conventional mapping strategies, ablation of complex fractionated electrograms and rotor ablation in atrial fibrillation ablation procedures, the identification and modification of the underlying arrhythmogenic substrate has emerged as a strategy that leads to improved outcomes. Arrhythmogenic substrate modification also has a major role in ventricular tachycardia ablation procedures. Optimisation of contact between tissue and catheter and image integration are a further step forward to augment our precision and effectiveness. Hybridisation of existing technologies with a reasonable cost should be our goal over the next few years.

Download Full-text

COMPATIBILITY OF ELECTROANATOMICAL MAPPING SYSTEMS WITH A CONCURRENT PERCUTANEOUS AXIAL FLOW VENTRICULAR ASSIST DEVICE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(14)60308-9 ◽

2014 ◽

Vol 63 (12) ◽

pp. A308

Author(s):

Vaibhav Vaidya ◽

Malini Madhavan ◽

Amit Noheria ◽

Christopher DeSimone ◽

Mohammed Shahid ◽

...

Keyword(s):

Ventricular Assist Device ◽

Axial Flow ◽

Electroanatomical Mapping ◽

Assist Device ◽

Ventricular Assist ◽

Mapping Systems

Download Full-text

A Zero-Fluoroscopy Approach to Cavotricuspid Isthmus Catheter Ablation: Comparative Analysis of Two Electroanatomical Mapping Systems

Pacing and Clinical Electrophysiology ◽

10.1111/pace.12376 ◽

2014 ◽

Vol 37 (8) ◽

pp. 1029-1037 ◽

Cited By ~ 21

Author(s):

ROSA MACÍAS ◽

INÉS URIBE ◽

LUIS TERCEDOR ◽

JUAN JIMÉNEZ-JÁIMEZ ◽

TERESA BARRIO ◽

...

Keyword(s):

Comparative Analysis ◽

Catheter Ablation ◽

Electroanatomical Mapping ◽

Cavotricuspid Isthmus ◽

Mapping Systems ◽

Zero Fluoroscopy

Download Full-text

Compatibility of Electroanatomical Mapping Systems with a Concurrent Percutaneous Axial Flow Ventricular Assist Device

Journal of Cardiovascular Electrophysiology ◽

10.1111/jce.12437 ◽

2014 ◽

Vol 25 (7) ◽

pp. 781-786 ◽

Cited By ~ 10

Author(s):

VAIBHAV R. VAIDYA ◽

CHRISTOPHER V. DESIMONE ◽

MALINI MADHAVAN ◽

AMIT NOHERIA ◽

MOHAMMED SHAHID ◽

...

Keyword(s):

Ventricular Assist Device ◽

Axial Flow ◽

Electroanatomical Mapping ◽

Assist Device ◽

Ventricular Assist ◽

Mapping Systems

Download Full-text

Assessment of the Knowledge of CT Scanner Operators on the Use of Dose Reduction Software Called Automatic Exposure Control (AEC) During a CT Scan

10.21203/rs.3.rs-754054/v1 ◽

2021 ◽

Author(s):

Eddy Fotso Kamdem ◽

Odette Ngano Samba ◽

Serge Abogo ◽

Joshua Tambe ◽

Jean Claude Mballa Amougou ◽

...

Keyword(s):

Medical Imaging ◽

Ionizing Radiation ◽

Dose Reduction ◽

Radiation Protection ◽

Ct Scanner ◽

Wrong Answer ◽

Public And Private ◽

Potential Risks ◽

Radiology Technicians ◽

Public And Private Hospitals

Abstract Objectif : Evaluate the knowledge of medical imaging technicians on the use of dose reduction software and the concept of patient radiation protection.Materials and methods : Descriptive and analytical transversal study from January 1 to December 1, 2020, conducted in the radiology and medical imaging services of Cameroon's public and private hospitals with a CT scanner. It was the first study on this topic that was conducted in Cameroon. This study was conducted from a questionnaire distributed to all medical imaging technicians in 10 country hospitals relating to the notions of dose reduction software and patient radiation protection.Results: 80 questionnaires were distributed and analyzed. The average age of medical imaging technicians was 30 years old. There were 32 women and 48 men. Most of the medical imaging technicians worked in private centers (n = 6). 75% of medical imaging technicians had been in practice for more than 5 years. 75% of medical imaging technicians gave the wrong answer regarding the use of dose reduction software. Finally, only a third of the practitioners had received training in patient radiation protection.Conclusion : Although the majority of medical imaging technicians declares to take into account the dangers related to ionizing radiation during examinations, a broader dissemination of patient radiation protection training and the use of dose reduction software, particularly during the initial curriculum. Radiology technicians could be one of the solutions to improve the knowledge of hospital practitioners in patient radiation protection. However, the use of ionizing radiation, however, need to know and take into account the potential risks of radio-induced cancer linked to high X-ray doses.

Download Full-text