A World First at the Princess Grace Hospital

The magnetic navigation equipment available at the CHPG, which exists only in a few centres in Europe, is a true revolution in the catheterization of cardiac cavities. The system has recently been customized by Professor Saoudi’s cardiology unit and features a new application. Technically, magnets are fitted onto the tips of the electrode catheters to be placed in the cardiac cavities. They are then subjected to an intense magnetic field which is artificially created around the thorax by rotating magnets controlled by a computer. This enables the tip of the catheter to be positioned anywhere on the heart with extreme precision, including the areas that are difficult or impossible to reach in cases when doctors have to use a classical type catheter. The new application was found in a patient who urgently needed a cardiac stimulator, but for whom classical implantation had failed twice due to a particular cardiac condition. The right atrium was in fact so dilated and damaged that it was impossible to fix a probe. It was therefore suggested that an examination by extensive mapping of the cavity be carried out, guided by magnetic navigation and coupled with a tri-dimensional marker system for the positioning of the catheter in the heart. Consequently, a profile of the right atrium appeared on the computer screen in virtual reality, with highly precise measures of the amplitude of the local electric activity at each point, indicating the presence of sufficient stimulable cardiac muscle for a probe to be secured at a local level. The atrium was so dilated that virtually the whole surface was not stimulable, except for a small area of a few square millimetres. Once the healthy area had been identified, magnetic navigation enabled a probe to be attached to the wall which could then be used as a target for the second operator. The latter, using radiological monitoring was able to place the probe enabling the cardiac stimulator to be implanted. The patient’s condition immediately improved and subsequent progress was straightforward. This technique, which was developed entirely in the Princess Grace Hospital, has never been carried out on a human before. Thanks to this breakthrough, a solution, which did not exist previously, was found for this patient (and most probably for other similar cases in the future). 

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