Initial Experience with MediguideTM Technology in Cardiac Resynchronization Therapy Device Implantation

Citation : E. Kevin Heist, Moussa Mansour, Jeremy Ruskin

Cardiac Resynchronization Therapy (CRT) is an important and expanding treatment for systolic heart failure associated with ventricular dyssynchrony. CRT implant procedures are frequently associated with prolonged radiation exposure which is typically substantially greater than exposure from conventional single and dual chamber devices, and which increases the risk of radiation-induced illness, particularly cancer, for both patients and implanting physicians and staff. MediGuide™ technology has been developed for CRT implantation, involving miniature sensors located in inner and outer guiding catheters and in the .014” guidewire which can be tracked in 3 dimensional space without the need for fluoroscopy during large portions of left ventricular lead implantation. Early results from pre-clinical and clinical implants have demonstrated significant decreases in fluoroscopic exposure when MediGuide™ is used to guide CRT placement. In this chapter, we discuss the MediGuide™ tools which are currently developed for CRT, describe the implant technique using this technology, and report the experience to date with this approach.