CardioInsight 3D: o noua tehnica de tratare a aritmiilor/ CardioInsight 3D: 3D Cardiac Mapping Inside Out

Aritmiile cardiace -acele batai prea rapide, prea incete sau neregulate ale inimii- sunt cele mai des intalnite afectiuni cardiace. 

Aritmiile sunt produse de modificari ale semnalelor electrice care controleaza bataile inimii. Aceste modificari pot aparea daca celulele nervoase care produc semnalele electrice (asa numitul nod Sinoatrial) nu mai functioneaza corect, sau semnalele nu traverseaza inima pe “traseele” corecte. De asemenea, mai pot aparea cand alte celule nervoase (altele decat celulele nodului Sinoatrial) produc semnale electrice. 
 

Solutia, in aceasta situatie, este de a identifica celulele care produc deviatia semnalelor electrice si de a le distruge prin ardere (tehnica numita ablatie prin cateter). 
 

Identificarea celulelor problematice este un pas foarte important in succesul ablatiei. 

In prezent, pentru a identifica aceste celule, se genereaza o harta electroanatomica a inimii: un model 3D al inimii care este colorat in concordanta cu activitatea electrica. 

Aceasta din urma este obtinuta cu ajutorul unui cateter care are in capat un electrod.  Acesta masoare activitatea electrica a inimii in fiecare punct, informatia obtinuta fiind mapata peste modelul 3D cardiac.
 

O astfel de procedura dureaza aproximativ 2 ore, creaza disconfort pacientului deoarece este invaziva, poate fi riscanta si este scumpa. 

 

Medtronic propune o  solutie non-invaziva: harta 3D electroanatomica a inimii este obtinuta folosind o vesta cu electrozi pe care pacientul o poarta in timp ce este supus unui scaner CT (Computer Tomograf). 
 

Astfel, activitatea electrica a inimii obtinuta cu ajutorul celor 252 de electrozi este suprapusa peste modelul 3d obtinut in urma scanarii CT. 
 

Vesta permite obtinerea unei activitatii electrice simultane pentru intreaga inima, aceast lucru neputand fi realizat cu ajutorul cateterului, unde activitatea electrica este masurata punct cu punct.  
 

Conform delaratiei reprezentantilor companiei, harta 3D se poate obtine dintr-o singura bataie a inimii. 

 
Aceasta tehnica de identificare a celulelor responsabile de producerea aritmiei, denumita CardioInsight 3D, tocmai a fost aprobata de FDA. 

 EN:

Cardiac arrythmias -heartbeats which are too fast, too slow or irregular- are the most common cardiovascular diseases. 

 

The modification of the electrical signals which control the heartbeats, generate the cardiac arrythmias.  These modifications might occur, if the nerve cells which generate the electrical signals (the ones from the so-called Sinoatrial node) do not work properly, or if these signals do not travel on the right “paths”. However, these modifications might also occur if other nerve cells (other than the nerve cells of the Sinoatrial node) generate electrical signals. 

 

When this occurs, the solution is to identify the “defective” cells and to turn them off (this technique is called “catheter ablation”). 

To identify accurately the “defective” cells is a very important step for conducting a successful ablation. 

Currently, an electroanatomic map is generated to identify these cells: a 3D cardiac model, mapped with the electrical activity of the heart. 

The latter is obtained with a catheter with an electrode at one of its tips. The electrode measures the electrical activity of the heart point by point, after which this information is mapped in the 3D cardiac model.

Such a procedure takes about 2 hours, can be very uncomfortable for the patient because of its invasiveness, causes serious health risks, and is expensive. 


Medtronic proposes a new, non-invasive solution: in it, the 3D electroanatomic map is obtained using a vest with electrodes, which is worn by the patient during a CT scan.
 

With this vest, the elecrical activity of the heart is acquired by 252 electrodes (attached to the vest) and is mapped in the 3D cardiac model, obtained during the CT scanning. 

 

The vest allows acquisition of the electrical acitivity for the whole heart, which is impossible using a catheter which measures the signals point by point. 

 

According to Medtronic, the 3D cardiac map can be obtained from a single heartbeat. 

 

This 3D cardiac mapping, called CardioInsight 3D, has just received FDA clearence.