Newmarket, Ontario (March 27, 2007) – Southlake Regional Health Centre in Newmarket is the first hospital worldwide to introduce a new, groundbreaking technology that vastly improves the treatment of cardiac patients and reduces exposure to x-rays.
Targeted at people who suffer from debilitating and often life-threatening arrhythmias (irregular heartbeats), the system combines a cardiac ultrasound probe with specialized heart mapping software. It is used to generate precise three-dimensional (3D) images of the heart or individual heart chambers so that physicians can pinpoint exact locations requiring treatment, eliminating the need for exposure to time-consuming CT Scans and MRIs.
“With this system, we are able to navigate a patient’s heart in real-time using live three-dimensional ultrasound images,” says Southlake electrophysiologist Dr. Atul Verma, one of the first physicians to use the breakthrough equipment. “You can take a computer mouse and literally trace the different structures in the heart, applying different views, and then the computer uses those tracings to generate a 3D picture,” he explains, noting that the better a physician can see into a patient’s heart, the better they will perform complex procedures like ablation, a common treatment for arrhythmia which requires extremely small and specific areas of heart tissue to be burned in order to return a normal rhythm.
Referred to as a diagnostic ultrasound catheter, the specialized probe relies on wires inserted into a heart intravenously, through veins in a patient’s leg and neck, to collect and send data to a computer where specialized mapping software generates the 3D images. Dr. Verma likens the process to a global positioning system (GPS). “Just as a GPS provides a real-time view of roads as opposed to looking at a map from your glove compartment that may be 10 years old, now we can see the heart in real-time and that really makes a difference,” he says.
Up until now, cardiac centres have relied on high resolution CT Scans and MRIs to provide images of the heart. Although this process is effective, the images are usually taken several days in advance of a procedure and therefore aren’t as exact as a real-time view. “The heart rhythm and heart size is constantly changing, even beat to beat you can get differences in the volume of blood which tend to distort and reshape the anatomy,” says Dr. Verma. “Granted the size is not changing by a huge amount, but sometimes the areas we’re targeting for ablation are within millimetres of certain structures so even the smallest change can make a difference,” he explains.
With the new technology, patients no longer have to wait for CT Scans and MRIs, there’s no risk associated with exposure to x-ray, and because physicians are using a more precise “map” of the heart, there’s less overall risk to the patient. Southlake Regional Health Centre has already conducted five ablation procedures using the new ultrasound navigation system, with promising results. A dozen more are scheduled between now and the end of April, with the next groundbreaking procedure scheduled for March 28, all of which will be closely watched by prominent physicians from the U.S. and elsewhere in the world.
“It will take a few months to fully determine our success, but I expect to see our success rate for complex ablation procedures improve,” says Dr. Verma. “The tools we use to treat arrhythmia haven’t changed; what’s new is our ability to visualize where we’re going and to be more precise about the areas we’re treating.”
Treating patients with complex arrhythmias requires specialized training and expertise. The CARTO XP technology, distributed by Markham-based Biosense Webster Canada, a unit of Johnson & Johnson Medical Products, is the latest approach to treat this significant complex disease. Over the past four years, Southlake physicians have gained an international reputation for treating close to 600 arrhythmia patients per year of which 200 are complex using a version of the ultrasound catheter without the innovative mapping software and achieving a cure rate close to 80 per cent for a disorder considered incurable less than 10 years ago.
Dr. Verma estimates that as many as 400,000 Canadians suffer from atrial fibrillation, the most common type of heart arrhythmia. Left untreated, this condition has the potential risk of stroke or heart failure. Not only will the new ultrasound catheter with heart mapping software make it safer and easier for physicians to correct such irregularities in the heart, Canadians don’t have to travel south of the border for state-of-the-art care as they traditionally might have, he says.
“Most of our patients are coming from Ontario right now but we treat people from as far away the Atlantic provinces, the Northwest Territories and British Columbia,” says Dr. Verma.
For Whitby resident Jack Van Rhee, the new procedure has been a life-changing experience. “I feel great. I no longer have heart palpitations. I feel like a new man,” said Van Rhee, who was the second patient to undergo the procedure, which was performed by Southlake Regional Health Centre’s Dr. Yaariv Khaykin on February 22.
Once the launch of the new equipment is complete, the procedure will start to be implemented at a handful of select sites across the world, including world-renowned U.S.-based clinics like the Cleveland Clinic and Mayo Clinic. Ultimately, the technology will be available in hospitals internationally.