In heart failure, the muscles on either side of the heart beat out of synchronization. This means that instead of efficiently pumping blood from the heart to the body when the heart “beats”, the heart ejects only a fraction of the blood it contains and the rest pools in the heart, causing swelling of the heart and a debilitating deficiency of oxygen in the patient’s body. The pooling of blood in the heart can also lead to formation of clots followed by stroke or sudden cardiac death (click here for classifications chart).

A new therapy, dual chamber cardiac resynchronization therapy (CRT), or bi-ventricular pacing, has shown promise in the treatment of a certain type of heart failure in which the left and right sides of the left ventricle do not contract at the same time. The procedure used to carry out this therapy involves the placement of a pacemaker lead into the coronary venous system of the heart. These devices have been shown to improve patients’ survival and quality of life by enabling the heart to pump more effectively and regularly. These CRT devices were implanted in almost 100,000 patients in 2005.

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In Cardiac Resynchronization Therapy, pacing leads are placed at multiple sites within the heart and attached to an implanted pacemaker which synchronizes the contractions of the heart to improve cardiac output.

A typical manual CRT procedure begins with the physician making a small incision in the skin near the patient’s shoulder. Pacing leads are advanced through the vein into the heart. One of these leads must be carefully positioned, using a guidewire, within the veins on the left side of the heart. Once the leads are in position, the pacemaker is implanted under the skin near the shoulder and programmed to meet the patient’s needs.

Many patients can benefit from CRT and return to normal lifestyles. However, roughly 10% of CRT procedures are unsuccessful, primarily due to difficulty in obtaining an adequate location for the left pacing lead. Additionally, nearly 30% of patients who are successfully implanted fail to experience a significant improvement in their condition.

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Current medical literature suggests that pacing lead placement has a significant impact on clinical outcomes in CRT. The Stereotaxis Magnetic Navigation System is particularly well suited to assist the physician in positioning the pacing lead on the left side of the heart. By enabling precise, computerized magnetic control of the tip of the guidewire, the Stereotaxis System can provide the physician with the ability to access and evaluate multiple locations in the left heart to optimize CRT function, potentially improving patient outcomes.

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Stereotaxis’ magnetic computerized CRT procedures and solutions are designed to bring precise direct control of the working end of the guidewire and comprehensive integration of imaging information in order to facilitate accurate pacing lead placement with the objective of providing:

• Increased likelihood that eligible patients can be successfully treated interventionall
• Shorter, simpler CRT procedures with better outcomes
• Lead placement optimization resulting in better long term response rates

For more detailed information, consult your physician or click on the related links.

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