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Medic-All Cardiac Electrophysiology Team, Taichung VGH 〉 Complex arrhythmia ablation (AF/VT Ablation) with 3D mapping

Complex arrhythmia ablation (AF/VT Ablation) with 3D mapping

Complex arrhythmia ablation (AF/VT Ablation) with 3D mapping

1.3D mapping assisted complex arrhythmia ablation (AF/VT Ablation). 2.Congenital heart disease or structure heart disease associated complex arrhythmia ablation

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Overview
Physicians within the Electrophysiology team are responsible for treating patients with a variety of rhythm disorders. In addition, our facility has 3 catheter laboratories, where one of them is specifically for both catheter ablation and device implantation. Over the past 5 years, the case numbers of catheter ablation has been increasing each year, with an almost 2.5-fold increase as compared to that in 2011. In 2015, we completed 288 cases of ablation, where the cases performed using 3-D mapping systems accounted for approximately 20% of the total ablation cases. In 3-D mapping cases, atrial fibrillation (AF) accounted for 59% of the total. The ablation procedure typically used in AF by our team is radiofrequency catheter ablation assisted by a 3-D mapping system (Ensite NavX system). The initial results found in AF ablation were favorable, with a single-procedure success rate of 83.3%, and a multiple-procedure success rate of 88.9%. Medtronic Arctic Front Advance Cryoballoon was introduced for paroxysmal AF ablation since October. 2014. At present, our institute is one of three hospitals in Taiwan which is capable of performing Cryoballoon ablation. Because the use of Cryoballoon ablation for paroxysmal AF is not currently being reimbursed by National Health Insurance, it has greatly limited the use of the procedure. Thus far, there have been 18 cases which we have completed using Cryoballoon ablation technique.

Device therapy treatments are also very important medical services which we have provided in the past. For rhythm disorders, including bradycardia, life-threatening tachy-arrhythmia, and drug-refractory heart failure, our case number of device therapy treatments (including pacemaker, implantable Cardioverter Defibrillators ICD, and Cardiac Re-synchronizing Therapy CRTP/D) has been approximately 170-290 procedures per year.
Features
Over the past 5 years, the case numbers of catheter ablation has been increasing each year, with an almost 2.5-fold increase as compared to that in 2011. In 2015, we completed 288 cases of ablation, where the cases performed using 3-D mapping systems accounted for approximately 20% of the total ablation cases. In 3-D mapping cases, atrial fibrillation (AF) accounted for 59% of the total. The ablation procedure typically used in AF by our team is radiofrequency catheter ablation assisted by a 3-D mapping system (Ensite NavX system). The initial results found in AF ablation were favorable, with a single-procedure success rate of 83.3%, and a multiple-procedure success rate of 88.9%. Medtronic Arctic Front Advance Cryoballoon was introduced for paroxysmal AF ablation since October. 2014. At present, our institute is one of three hospitals in Taiwan which is capable of performing Cryoballoon ablation.
Service Procedure
Electrophysiology is the study of electrical activity in the heart; how the heart beats. Our doctors are cardiologists who specialize in the electrical system of the heart.

Cardiac electrophysiologists (arrhythmia specialists) rely on a patient's medical history and the results of a variety of procedures to diagnose heart rhythm abnormalities. Once the electrical disorder is diagnosed, the arrhythmia specialist works with your doctor to determine the risk of the heart rhythm abnormality and recommend treatment. Together, you, your primary care doctor or general cardiologist, and the arrhythmia specialist decide on the most appropriate treatment for you.

To be evaluated for an abnormal heart rhythm, one of our physicians will first examine you at the Johns Hopkins Outpatient Center or Johns Hopkins Bayview Medical Center, or at one of our community sites -- Green Spring Station, White Marsh, Odenton, Greater Baltimore Medical Center (GBMC) in Towson, or Columbia. If necessary, you may be asked to undergo one or more of the following tests:
  • An electrocardiogram (called ECG or EKG), records your heart's electrical activity during rest to determining abnormal rhythms
  • A Holter monitor to record your heart's activity during a 24-hour period or longer. Small sensors applied to your skin are connected to a small recording device that is strapped or belted to your body. This is useful for detecting abnormalities that may not occur during an electrocardiogram
  • An event monitor, which records the heart rhythm only when activated and is usually worn for about a month.
  • An exercise stress test also known as treadmill tests, help determine irregular heart rhythms during exercise. During this test, the heart's electrical activity is monitored through small metal sensors applied to your skin while you exercise on a stationary bicycle or treadmill.
  • A tilt table test may be in order if you experience lightheadedness or fainting. You will be placed on a table that starts in a horizontal position and is then tilted upward at different angles while your heart rate and blood pressure are measured.


Based on your diagnostic exam and test results, our physicians will work with you on a treatment plan which may include:
  • managing electrical abnormalities with medication
  • using radio wave energy to destroy specific areas of the heart causing abnormal rhythm
  • implanting a pacemaker that triggers the heart if it is beating too slowly 
  • implanting a defibrillator to keep the heart from beating too rapidly 


We are pleased to provide all of our patients with a Comprehensive Guide to Our Electrophysiology and Arrhythmia Service.
Notification
AF complication rate:
Estimated Cost
(Prices listed below are for reference. Actual cost may be according to the real expense during the hospitalization.)
AF: NTD 108,000~280,000 (USD 3,484~9,032)
VT: NTD 46,000~112,000 (USD 1,484~36,123)
Other complex arrhythmia: NTD 46,000~108,000 (USD 1,484~3,484)
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