GPS guides path to the heart


St Andrew’s War Memorial Hospital the first hospital in the Southern Hemisphere to offer ground-breaking technology for safer heart procedures

St Andrew’s War Memorial Hospital announced today (Wednesday, 29 January, 2014) that it is the first hospital not only in Australia, but in the Asia-Pacific region and Southern Hemisphere, to acquire ground-breaking technology which provides a safer way for patients to undergo heart procedures by dramatically reducing radiation.

St Andrew’s has invested $1million in the MediGuide Technology. It will assist specialists during complex electrophysiology (EP) procedures to diagnose problems with the heart’s rhythm (arrhythmias) and to provide treatment therapies such as ablation (cauterising the problem area) and implant of cardiac pacemakers and defibrillators (known as a cardiac resynchronisation therapy, or CRT, devices). Heart rhythm disorders, when a malfunction of the heart’s electrical system causes the heart to beat too fast, too slow or irregularly, impact hundreds of thousands of Australians every year.

MediGuide incorporates technology that is similar to a GPS (global positioning system) in a car satellite navigation device or mobile phone which drivers use to check their location and movement on a map.

During conventional EP procedures, a continuous series of live X-ray images of the heart (fluoroscopy) is needed to show specialists the real-time position of electrode catheters (long, thin, flexible wires) threaded into the heart.

Using MediGuide, only a brief series of recorded fluoroscopic images is required. The MediGuide Technology uses miniature sensors embedded in catheters and other devices to superimpose a three-dimensional (3-D) visualisation of these devices over the prerecorded images to show the specialist their precise location inside the patient.

By reducing the time live X-rays are used, radiation exposure is cut substantially - overseas experience shows decreases of up to 90 percent using MediGuide can be achieved, depending on the type and duration of a procedure.

St Andrew’s cardiologist and a Director of Queensland Cardiovascular Group, Dr John Hayes, performed the first EP procedures at St Andrew’s using MediGuide yesterday (Tuesday, 28 January), in the presence of Dr Philipp Sommer, Associate Professor at the University of Leipzig, Germany, who has utilised the technology in more than 350 cases.

"We are excited that St Andrew’s is the first hospital in the Southern Hemisphere to have this technology," Dr Hayes said.

"Rather than using GPS satellites in the sky we have, in effect, a couple of satellites in the X-ray equipment using low-frequency electromagnetic signals to track miniature sensors in the catheters and other devices to guide us. On the prerecorded X-rays on the screen we can see the heart and vascular anatomy and the movement of the catheters in real time without taking any extra X-rays. 2

"Reducing radiation exposure to patients is very important because the more radiation anybody is exposed to, the greater the cumulative risk of developing cancers. Patients with cardiovascular disease may have to undergo many tests and procedures that involve radiation in their lifetimes. Not just EP procedures, but CT scans and angioplasty (widening the arteries) and stenting (placing a small tube in the artery to keep it open)."

Deputy Chief Medical Officer for UnitingCare Health and Director of Medical Services at St Andrew’s War Memorial Hospital, Dr Christian Rowan, said the acquisition of MediGuide further demonstrated the hospital’s commitment to innovation in healthcare and achieving world-class results for patients.

"St Andrew’s cardiologists have for many years been recognised as being at the forefront of electrophysiology and therapies for arrhythmias," Dr Rowan said. "Being the first hospital in the Southern Hemisphere to utilise this new MediGuide Technology reaffirms that we continue to lead the way.

"It is also part of our ongoing efforts to reduce the risk to patients from radiation through both the use of available technologies and clinical techniques. For example, the effective radiation dosage levels in our EP laboratory for ablations to treat atrial fibrillation (AF), the most common type of arrhythmia, are at 25 per cent of what they were in 2007. MediGuide Technology offers the opportunity to reduce that further.

"Benchmark studies have also shown that for a variety of procedures St Andrew’s radiation exposure levels are lower than those in many other electrophysiology laboratories and hospitals around the world."

Last year, around 600 electrophysiology (EP) procedures were performed at St Andrew’s War Memorial Hospital, of which 200 were complex atrial fibrillation (AF) ablations. St Andrew’s specialists also last year performed 400 cardiac pacemaker implants and generator changes, and 200 cardiac defibrillator implants and generator changes.