title: MediGuide in supraventricular tachycardia: initial experience from a multicentre registry.
abstract: OBJECTIVE
  Currently, fluoroscopy-based catheter visualization is the standard modality in invasive electrophysiological procedures. Recently a new technology for non-fluoroscopic visualization of diagnostic (since 2010) and ablation catheters (since May 2012) has been introduced. The MediGuide™-Technology (MediGuide) projects catheter tips on prerecorded cine loops in a high time resolution.
  
  
  RESULTS
  We report on MediGuide-based supraventricular tachycardia (SVT) cases [atrioventricular nodal reentry tachycardia (AVNRT), atrioventricular reentry tachycardia (AVRT), Wolff-Parkinson-White syndrome (WPW), ectopic atrial tachycardia (EAT) and typical atrial flutter) from two European centres. In all patients, diagnostic and/or ablation catheters with a special sensor were used to perform the ablation procedures. All procedural data such as acute success, duration of the procedure, fluoroscopy time, and dose and patients' characteristics were analyzed and compared with conventionally ablated patients (n = 1865). Procedure-related complications during the hospital stay were recorded. A total of 24 consecutive patients were analyzed: no significant difference to the control group was seen in the baseline characteristics. The MediGuide patients were predominantly male (66%), aged 58 ± 14 years and were ablated for 6 AVNRT (25%), 4 AVRT/WPW (17%), 1 EAT (4%), and 13 typical atrial flutter (54%). The acute success rate was 100% (98% in the control group, n.s.). The median fluoroscopy time was 0.5 ± 1.4 min (10.2 ± 9.6 in the control group, P < 0.001), the median fluoroscopy dose was 187 ± 554 cGy cm(2) (996 ± 2593 cGy cm(2), P < 0.05). Mean procedure time was 70 ± 25 min (60 ± 36 min, n.s.). No complications during the hospital stay were recorded.
  
  
  CONCLUSIONS
  In several different forms of supraventricular tachycardias the MediGuide-Technology contributed to a dramatic reduction in irradiation exposure. With a median fluoroscopy time of 30 s all SVT cases were effectively performed with no complications; the fluoroscopy burden can be significantly reduced not only for the patient but also for the nurses and the physicians performing the case. The overall procedure times are not prolonged due to the use of MediGuide Technology compared with a control group of >1800 patients undergoing conventional ablation procedures.
authors.affiliation: Department of Electrophysiology, Heart Center, University Leipzig, Struempellstr. 39, Leipzig 04289, Germany. philipp.sommer@herzzentrum-leipzig.de
authors.forename: Philipp
authors.initials: P
authors.lastname: Sommer
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.forename: Thomas
authors.initials: T
authors.lastname: Gaspar
authors.forename: Charlotte
authors.initials: C
authors.lastname: Eitel
authors.forename: Michael
authors.initials: M
authors.lastname: Derndorfer
authors.forename: Martin
authors.initials: M
authors.lastname: Martinek
authors.forename: Helmut
authors.initials: H
authors.lastname: Pürerfellner
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
authors.forename: Sascha
authors.initials: S
authors.lastname: Rolf
mesh_terms: D001317:Austria / Q000453:epidemiology; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D025321:Surgery, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data*; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome
keywords: Ablation; Catheter visualization; Fluoroscopy; Supraventricular tachycardia