October 9, 2012

New technology allows KU Hospital to navigate through hearts

The technology guiding the GPS navigator in your car has started working its way into the hearts of patients at the University of Kansas Hospital.

The technology guiding the GPS navigator in your car has started working its way into the hearts of patients at the University of Kansas Hospital.

Doctors there are the first in the country to use a new system that allows them to drastically reduce the amount of radiation used while they insert catheters to treat heart abnormalities.

There’s been a movement over the past year or two with doctors trying to reduce how much X-ray exposure patients have over their lifetime, said Loren Berenbom, director of the hospital’s Richard and Annette Bloch Heart Rhythm Center.

Here’s how it works:

Typically, doctors use fluoroscopy, or a rapid sequence of X-rays, to see the heart and find their way around witha catheter. That method, however, results in relatively long periods of radiation — anywhere from 15 or 20 minutes to an hour or more for complex procedures.

With the new system, called MediGuide Technology, doctors need to use radiation just once, for a much shorter time, instead of using it throughout the procedure. The X-ray serves as a base map.

Then they use catheters with sensors at their tips that form a three-dimensional world inside the patient’s body, showing doctors where they are inside the heart and guiding them to the damage they need to repair.

“A lot of the medical technology has moved toward the adoption of GPS technology,” said Dhanunjaya Lakkireddy, an electrophysiologist at the hospital. “This is one other way of making a procedure more safe.”

Lakkireddy said the new system, which was approved for use in 2009 by the Food and Drug Administration, was an “enormous” step in efforts to minimize the amount of radiation patients are exposed to during procedures.

MediGuide, from St. Jude Medical Inc., was first used in Leipzig, Germany, where doctors from KU Hospital traveled for training. Seeing the technology at work firsthand made it easier for doctors to adopt it at home, said cardiologist Raghu Dendi.

The first patient at KU was 53-year-old Sarah Howard of Holt, Mo., who has supraventricular tachycardia, a rapid heart rhythm that originates above the ventricles of the heart.

Doctors had used the traditional procedure to treat her condition in the past, and she was excited about the shorter period she would be exposed to radiation this time.

“When I found out I was the first person in the country, I felt like I won the lottery,” she said, laughing.

Howard’s procedure usually would have required her to be exposed to 15 to 20 minutes of fluoroscopy. It took doctors only four minutes’ worth of radiation with the new technology.

In a procedure done on another patient Monday morning, doctors were able to cut the amount of time spent under radiation by about 90 percent.

“We know it’s safer for the patient,” cardiologist Martin Emert said. “We know it’s safer for us and our staff. It’s a technology that makes things better without being harmful.”

Cardiologist Rhea Pimentel works with young patients for whom the long-term effects of radiation are uncertain.

“You always have that concern when you’re doing these procedures,” she said. “What’s going to happen 20 years from now? This sort of allows us the freedom to do these procedures without the worry.”

The procedure has a sizable price tag, Berenbom said, but the hospital has absorbed most of the cost, and patients shouldn’t see increased charges because of it.

Dendi, Emert and Pimentel returned from Germany on Wednesday, and by Thursday’s end, Emert had done two procedures with the new technology. The doctors looked at the ceiling as they counted out how many times they’ve used MediGuide.

So far, seven.

“No time like the present, right?” Pimentel said.

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