- Email: [email protected]
Renal Sympathetic Denervation Using an Electroanatomic Mapping System
Journal of the American College of Cardiology Ó 2014 by the American College of Cardiology Foundation Published by Elsevier Inc.
Vol. 63, No. 16, 2014 ISSN 0735-1097/$36.00 http://dx.doi.org/10.1016/j.jacc.2013.11.065
IMAGES IN CARDIOLOGY
Renal Sympathetic Denervation Using an Electroanatomic Mapping System Marc A. Miller, MD, Sandeep R. Gangireddy, MD, Srinivas R. Dukkipati, MD, Jacob S. Koruth, MD, Andre d’Avila, MD, PHD, Vivek Y. Reddy, MD New York, New York
From the Helmsley Electrophysiology Center, Mount Sinai School of Medicine, New York, New York. Drs. d’Avila and Reddy have received speaking honoraria and grant support from Biosense-Webster and St. Jude Medical, the manufacturer of the electroanatomic mapping system (NavX) and ablation catheter (BiosenseWebster) used in this case. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. A portion of this paper was presented at the American Heart Association Scientific Sessions in Los Angeles, California in 2012. Manuscript received March 25, 2013; revised manuscript received October 28, 2013, accepted November 22, 2013.
54-year-old man with refractory hypertension presented for catheter-based renal sympathetic denervation. Three-dimensional (3D) geometric reconstruction of the renal arteries and real-time visualization of the ablation catheter were performed with an irrrigated straight-tipped ablation catheter. The ablation catheter was located in the left renal artery (anteroposterior projection) during the application of the fourth ablation lesion (proximal and superior location) (A) and a superior-inferior view during the same ablation lesion (B). The white circles represent prior ablation lesions (sequential order). Experience with cardiac ablation procedures has revealed that 3D electroanatomic mapping (EAM) systems can improve procedural efficacy and reduce total radiation exposure, by providing a better 3D understanding of catheter location relative to the target tissue (1). Employing EAM for 3D reconstruction of the renal arteries and real-time visualization of the ablation catheter during renal sympathetic denervation has the potential to yield similar benefits, but further studies are required. The numbers in each panel (1,2,3,4) refer to the sequential order of ablation applications (4 ablation applications in total).
A
REFERENCE
1. Estner HL, Deisenhofer I, Luik A, et al. Electrical isolation of pulmonary veins in patients with atrial fibrillation: reduction of fluoroscopy exposure
and procedure duration by the use of a nonfluoroscopic navigation system (NavX). Europace 2006;8:583–7.
Vol. 63, No. 16, 2014 ISSN 0735-1097/$36.00 http://dx.doi.org/10.1016/j.jacc.2013.11.065
IMAGES IN CARDIOLOGY
Renal Sympathetic Denervation Using an Electroanatomic Mapping System Marc A. Miller, MD, Sandeep R. Gangireddy, MD, Srinivas R. Dukkipati, MD, Jacob S. Koruth, MD, Andre d’Avila, MD, PHD, Vivek Y. Reddy, MD New York, New York
From the Helmsley Electrophysiology Center, Mount Sinai School of Medicine, New York, New York. Drs. d’Avila and Reddy have received speaking honoraria and grant support from Biosense-Webster and St. Jude Medical, the manufacturer of the electroanatomic mapping system (NavX) and ablation catheter (BiosenseWebster) used in this case. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. A portion of this paper was presented at the American Heart Association Scientific Sessions in Los Angeles, California in 2012. Manuscript received March 25, 2013; revised manuscript received October 28, 2013, accepted November 22, 2013.
54-year-old man with refractory hypertension presented for catheter-based renal sympathetic denervation. Three-dimensional (3D) geometric reconstruction of the renal arteries and real-time visualization of the ablation catheter were performed with an irrrigated straight-tipped ablation catheter. The ablation catheter was located in the left renal artery (anteroposterior projection) during the application of the fourth ablation lesion (proximal and superior location) (A) and a superior-inferior view during the same ablation lesion (B). The white circles represent prior ablation lesions (sequential order). Experience with cardiac ablation procedures has revealed that 3D electroanatomic mapping (EAM) systems can improve procedural efficacy and reduce total radiation exposure, by providing a better 3D understanding of catheter location relative to the target tissue (1). Employing EAM for 3D reconstruction of the renal arteries and real-time visualization of the ablation catheter during renal sympathetic denervation has the potential to yield similar benefits, but further studies are required. The numbers in each panel (1,2,3,4) refer to the sequential order of ablation applications (4 ablation applications in total).
A
REFERENCE
1. Estner HL, Deisenhofer I, Luik A, et al. Electrical isolation of pulmonary veins in patients with atrial fibrillation: reduction of fluoroscopy exposure
and procedure duration by the use of a nonfluoroscopic navigation system (NavX). Europace 2006;8:583–7.