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Improving Ventricular Tachycardia treatment

#Ventricular_tachycardia #Epicardial_approach #Ablations #VT #VT_ablation


Catheter ablations are used to treat a number of cardiac conditions all over the world, including ventricular tachycardia. Ventricular tachycardia, which is responsible for ~300,000 deaths in the U.S. per year (1), is a condition in which electrical signals within the heart are sent too quickly, causing very fast, disorganized heart activity. Due to the rapid heart rhythm, the heart does not have enough time to fill between contractions. Consequentially, the heart is not able to pump enough blood to the rest of the body. In itself , a few seconds of ventricular tachycardia could render harmless. The fear with VT is, however, that it may lead to ventricular fibrillation, a condition in which the heart beats in such an irregular fashion that it causes the heart to stop working (cardiac arrest). Therefore, it is important to get VT treated and today, the most common way of getting it treated is with a catheter ablation procedure.


In VT cardiac ablations, the portion of the heart from which the rapid signal firing originates from is identified and burned via radio frequency energy. This is traditionally done by placing a long, thin catheter into the heart ventricles. Once the critical area/s of the arrhythmia is/are identified, radio frequency energy is delivered to the area/s, burning the overactive tissue.



Some Facts & Figures

An estimated total of 519,951 ablations were performed in the United States between 2000 and 2013 (2), and the numbers have only been rising since then. The numbers now fall at a whopping “six patients per 10,000 of the world population annually” (3) or 4,560,000 patients worldwide per year. The problem? There is an even larger window of people that could benefit from a catheter ablation that are not yet being treated with one. And the source of the problem? The lack of pericardial access.



Epicardial treatment is better

The pericardium is a very thin-walled sac that encloses the heart. Despite many advancements in cardiac medicine over the past few decades, safe access to the pericardium remains a mystery to many physicians. And why would a physician want access to the pericardium? Although traditionally, cardiac ablations have been performed endocardially (from within the heart chambers) “the last decade has seen the rise of epicardial ablations” (4). An epicardial approach has been proven not only safer, due to the invasiveness of traditional endocardial ablations, but also more effective, having been “associated with fewer readmissions for VT and repeat ablations” (5).

Experts have recognized a beneficial advancement in modern cardiac medicine, even calling the pericardium “an underutilized therapeutic site”(6), yet they still stand at the same deadlock that has trumped experts for decades: how does one access the pericardium without damaging the heart muscle itself? And that is where CardioVia comes in, CardioVia strives to overcome this obstacle in the way of shifting unsafe and highly invasive endocardial procedures into epicardial ones and will do so by creating a safe access point to the pericardium. Once safe access is secured, cardiac ablations can be performed with more safety and efficiency providing the physician assurance he won’t puncture the heart.



Sources:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744510/

2. http://electrophysiology.onlinejacc.org/content/early/2017/07/26/j.jacep.2017.05.005

3. https://academic.oup.com/eurheartj/article/38/17/1327/3074212

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613420/

5. https://www.ncbi.nlm.nih.gov/pubmed/26056239

6. https://www.ncbi.nlm.nih.gov/pubmed/29748197


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