Albuquerque, N.M. ─ June 15, 2015 ─ The New Mexico Heart Institute (NMHI) has announced that Dr. Santosh Oommen performed the first-ever catheter ablation for atrial afibrillation without x-ray in New Mexico on June 1, 2015 at Heart Hospital of New Mexico at Lovelace Medical Center.
“The Heart Hospital of New Mexico at Lovelace Medical Center is proud to provide the equipment and facilities necessary to perform procedures such as this in as advanced a manner as possible,” said Lovelace Medical Center CEO Troy Greer. “The combination of our leading-edge tools and technology and the good judgment and excellent ability of New Mexico Heart Institution physicians means that patient safety is never compromised for an excellent outcome, or vice versa.”
“This New Mexico-first reflects an ongoing effort on New Mexico Heart Institute’s part, and especially by the electrophysiology division, to reduce x-ray exposure to our patients,” said Dr. Oommen.
According to medical experts, there is no known amount of x-ray exposure that can be considered safe. While x-ray exposure, or fluoroscopy, is considered necessary for many cardiac procedures, physicians at NMHI have been working to reduce the amount of x-ray exposure necessary to safely perform procedures, and have eliminated the need for x-ray in many simple procedures, such as super ventrical tachycardia.
Dr. Oommen’s x-ray-free ablation this June marks the first time that such a complex procedure has been performed without any x-ray in the state of New Mexico. X-ray free catheter ablation was first pioneered by physicians at Mt. Sinai Hospital in New York City in 2010 and has been performed at a handful of other locations since then.
Dr. Sean Mazer, president of the NMHI Board of Directors and a cardiologist at NMHI, had previously set a benchmark of two minutes of x-ray exposure time while performing this same procedure at the Heart Hospital of New Mexico at Lovelace Medical Center.
“The equipment and tools exist to almost eliminate x-ray exposure,” said Dr. Oommen. “So we were asking ourselves, do we really need the x-ray anymore?”
In a typical catheter ablation for atrial afibrillation, a patient would be exposed to x-ray for up to 20 minutes. The procedure with x-ray also takes 10-12 hours to complete.
The new tools at Heart Hospital of New Mexico at Lovelace Medical Center include the Biosense Webster Carto ® 3 System, an advanced imaging technology that uses electromagnetic technology to create real-time three-dimensional maps of a patient’s cardiac structures. Using this tool, the physician can triangulate the location of catheters inside the body, which provides a better view for the physician.
“X-ray can fool you,” Dr. Oommen says. “A real-time, 3-D map provides a better target.”
The new tools help reduce the procedure’s time stamp from 10-12 hours to about three hours. Furthermore, efficacy of the procedure is increased from about 50 percent to 80 percent or more in eliminating afibrillation in the patient.
NMHI physicians will still use x-ray as necessary during trickier procedures. For instance, if a catheter proves more difficult to guide up into the heart or the transeptal puncture is more complicated, the performing physician may opt to use some x-ray. Still, the physicians hope to make the x-ray-free procedure standard.
The fact that physicians can perform complex procedures such as this without x-ray provides hope for further reducing the need for x-ray exposure in other procedures, too. The Heart Hospital of New Mexico at Lovelace Medical Center is in discussions with St. Jude Medical to acquire a system that could allow physicians to install pacemakers and defribillators in patients with minimal x-ray exposure.
“[X-ray free catheter ablation for atrial afibrillation] illustrates that complex ablation can be done without x-ray,” said Dr. Oommen. “It’s possible that other complex procedures such as ventrical tachycardia may not need x-ray in the future. We could massively reduce x-ray exposure to a large number of patients.”