Treat Every Arrhythmia with Personalized Solutions.

Treat Every Arrhythmia
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How We Treat Every Arrhythmia with Personalized Solutions.

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Electrophysiology / RHYTHMIA™ Cardiac Mapping System / DIRECTSENSE™ Technology / Case Studies

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Case Studies

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Case Studies

 
 

Atrial Fibrillation

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Atrial Fibrillation

DeNovo Atrial Fibrillation

A DeNovo PVI was performed on a PAF patient by first creating a CS-paced map with the INTELLAMAP ORION™ Mapping Catheter with the RHYTHMIA HDx™ Mapping System to assess Left Atrium voltage.

The INTELLANAV MIFI™ OI Catheter with DIRECTSENSE™ Technology was used for ablation with AUTOTAG coloring parameters set to Light Pink <14 Ω, Pink ≥14 Ω, Red ≥17Ω. During PVI, areas of fractionation were highlighted near the RSPV and LIPV using the LUMIPOINT™ Software Module’s complex activation tool.

Fractionated areas were ablated and a floor line was used to anchor them to the LPV and RPV and avoid future LAFL. Validation mapping confirmed PVI and floor line block. The total procedure time was 1:26.

“Local impedance is a very sensitive marker of field response. We notice variability changes when in contact with moving tissue versus more steady. [Local Impedance is a] nice way to tell different tissue properties.”

Video courtesy of Dr. Jose Cuellar Silva (HCA Houston Healthcare Clear Lake| Webster, Texas)

Low Fluro in AF, CTI Flutter and AT

Low Fluoro in AF, CTI Flutter and AT

This case video shows a RHYTHMIA HDxTM low fluoro procedure including a PVI, CTI Flutter and Atrial Tachycardia. Case time was 2.5 hours, with positive outcome and efficiency.

Video courtesy of Dr. Jose Cuellar Silva (HCA Houston Healthcare Clear Lake| Webster, Texas)

Paroxysmal Atrial Fibrillation

Paroxysmal Atrial Fibrillation

This patient with Paroxysmal Atrial Fibrillation had a second potential in the posterior wall (epicardial connection from CS). The signal was mapped to the roof and ablated. Signals from INTELLANAV MIFI™ OI Catheter begin walking out and disappear.

Video courtesy of Dr. Jose Cuellar Silva (HCA Houston Healthcare Clear Lake| Webster, Texas)

 
 

Atrial Tachycardia

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Atrial Tachycardia

Macroreentrant Circuit

A 66-year-old male, with previous PVI and CTI, presented in tachycardia. When the INTELLAMAP ORION™ Mapping Catheter was close to the LAA/LSPV ridge, the tachycardia terminated. The tachycardia was reinduced and the LA map was completed. Long, fractionated EGMs covering a majority of the cycle length were found at the ridge anterior to the LSPV.

LUMIPOINT™ Software Module’s SKYLINE™ tool confirmed a macroreentrant circuit at the ridge, corresponding with the fractionated EGMs. After approximately 1.5 seconds of ablation, the tachycardia was terminated.

Video courtesy of Dr. Bruce Hook (Lahey Hospital & Medical Center | Burlington, Massachusetts)

Atrial Tachycardia

Atrial Tachycardia

A smooth, single burn termination was used on this roof-dependent AT patient. With the use of RHYTHMIA HDx™ Mapping System’s high-density mapping, the critical isthmus was identified. The INTELLANAV MIFI™ Open-Irrigated Catheter also revealed key local signals.

Video courtesy of Dr. Christian Eickholt (St. George Heart Center, Asklepios HH | Hamburg, Germany)

Left Atrium Tachycardia

Left Atrium Tachycardia

The LUMIPOINT™ Software Module rapidly highlighted the isthmus. With support from DIRECTSENSE™ Technology, termination was achieved after 4 seconds of RF delivery time and a -12 Ω drop. The validation map and AUTOTAG showed a gap in the anterior line with LUMIPOINT’s trend tool showing local double potentials. After closing the anterior line, a second map showed the anterior line was blocked.

Video courtesy of Dr. Evgeny Lyan (HGZ Bad Bevensen | Bad Bevensen, Germany)

 
 

Atrial Flutter

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Atrial Flutter

Atypical Atrial Flutter

A 41-year-old male presented with a severely enlarged RA and incessant AT for a third redo. Entrainment maneuvers confirmed a localized re-entry around the RAA with at least two corridors of slow conduction. Dr. Frontera ablated the shorter isthmus.

Video courtesy of Dr. Antonio Frontera (San Raffaele Hospital | Milan, Italy) 

 
 

Ventricular Tachycardia

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Ventricular Tachycardia

Ventricular Tachycardia (PVC)

A patient presented experiencing a PVC every ~6th beat. Mapping the RV with the INTELLAMAP ORION™ Mapping Catheter, the RHYTHMIA HDx™ Mapping System and using the LUMIPOINT™ Software Module’s SKYLINE™ tool assisted with rapid identification of the true earliest activation at the basal mid-septal region.

At the site of earliest activation, DIRECTSENSE™ Technology was used to monitor stability and the micro-fidelity electrodes on the INTELLANAV MIFI™ OI Catheter allowed visualization of the fractionated signals during a PVC.

DIRECTSENSE Technology was used to guide ablation with AUTOTAG color parameters set to Light Pink <15 Ω, Pink ≥ 15 Ω, Red ≥ 20 Ω. The PVCs were terminated following ablation of the fractionated signals.  

IImage courtesy of Dr. Jason Chinitz (Southside Hospital | Bay Shore, New York)

Ventricular Tachycardia

Ventricular Tachycardia

Patient with a history of ischemic cardiomyopathy was treated for recurrent ventricular tachycardia. Dr. Gallagher utilized the RHYTHMIA HDx™, INTELLAMAP ORION™, and LUMIPOINT™ software module to map the entire tachycardia circuit. Local Impedance guided ablation with INTELLANAV MIFI™ OI terminated VT with a linear ablation through the critical isthmus. AUTOTAG demonstrate red tags with >15ohm drops.

Image courtesy of Dr. Peter Gallagher (Nebraska Heart Institute, Lincoln, Nebraska)

Outer Loop VT circuit

Outer Loop VT Circuit

This is a good demonstration of how the outer loop played a role in the VT circuit. During VT, a mean of 2 slow conduction pathways occurred at the outer loop, being longer and faster than those recorded at the VT isthmus. These outer loops were characterized mainly by border zone. This case was featured by the Heart Rhythm SocietySM in their Heart Rhythm publication. A subscription or one-time payment is required to access the full article.

Video courtesy of Dr. Antonio Frontera (San Raffaele Hospital | Milan, Italy) 

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