In March, new technology at the Wisconsin Heart Hospital in Wauwatosa will make the catheterization process easier and safer for physicians to maneuver a wire through a vein to the heart.
The catheters are typically inserted into a vein through a small incision in the groin area of a patient diagnosed with atrial fibrillation, a condition in which the electrical impulse of the heart is out of sync, and thus produces an irregular heart rhythm and often insufficient blood flow. The wire is manually maneuvered up through the patient’s vein and into the heart by pushing, pulling and steering it, using a handle at the opposite end of the catheter. Physicians maneuver the tip of the catheter around the heart and burn or “ablate” portions of the tissue away to interrupt the path of the irregular electrical impulse.
The Stereotaxis Magnetic Navigation System, designed and manufactured by St. Louis, Mo.-based Stereotaxis Inc., is the new machine that the Wisconsin Heart Hospital is adding that enables physicians to perform the exact same catheterization procedure by controlling much softer catheters using magnetic fields.
“The new catheters are absolute noodles,” said Dr. Peter Chapman, electro-physiologist with Wheaton Franciscan Medical Group’s heart rhythm specialists who works primarily at the Wisconsin Heart Hospital. “The softness of the new catheters makes them less potentially damaging to the patient.”
Maneuvering the catheters with magnets allows for movement by the precise millimeter in any direction by changing the position of the vectors of the magnets. Combining this feature with the soft touch of the catheter allows for safer, more precise ablations and a faster recovery time for the patient.
“We hope to get higher success rates and safer procedures,” Chapman said. “If we can do that, it becomes a better option for more patients with atrial fibrillation.”
In addition, the device allows for less exposure to X-rays for both physicians and patients. Currently, physicians working in traditional catheter labs with traditional equipment must use X-rays along with other technology to assist in maneuvering the catheter to the heart.
Technology referred to as X-ray fluoroscopic guidance allows physicians to see the entire length of the catheters inside the body, but also delivers harmful radiation to the patient and doctors inside the room.
The Stereotaxis device uses a digital three-dimensional mapping system to navigate the catheter through the body, and the physicians performing the procedure can do it from almost anywhere.
“The first time I saw this machine used, I was at a meeting in Boston,” Chapman said. “Carlo Paponi, who developed this technique for the atrial fibrillation, was doing a case on the computer using a mouse and a joystick, live from Boston, on a patient in Milan, Italy. It allows you to basically do it from anywhere.”
The heart hospital physicians will be performing the procedure from the windowed room directly adjacent to the patient, but the technology to do it from elsewhere is available.
Doctors at the Wisconsin Heart Hospital will be the first in the state to have this new technology available when the construction for the sixth catheter lab at the hospital containing Stereotaxis equipment is complete in March.
The machine will also be used by one or two of the interventional cardiologists to perform angioplasties, procedures where a small wire is inserted into the heart to open narrowed or blocked blood vessels.
“The interesting part about this is that it really has the ability to steer something anywhere in the body, so it has a lot of potential future uses,” he said.
