Real-Time Intracardiac Imaging Enables Better Surgical Control

New ultrasound imaging technology enables clinicians to view real-time images from inside the heart as they diagnose and treat conditions resulting from abnormal rhythms or structural problems. By providing clear, accurate images of the heart's interior anatomy and the position of devices, the new ultrasound system enables physicians to perform procedures with increased control.

St. Jude Medical, Inc. (St. Paul, MN, USA) announced the first use outside the United States of its ViewMate II ultrasound system with the ViewFlex plus intracardiac echocardiography (ICE) catheter. The technology was presented in January 2009 at the Boston (MA, USA) Atrial Fibrillation Symposium.

The ViewMate system uses ultrasound technology to produce high-resolution intracardiac images. The system transmits high-frequency sound waves through a transducer on the tip of the catheter--the transducer converts electric energy into sound energy, the sound waves then reflect off structures inside the heart and the transducer converts them back into electric energy to generate the anatomic images.

The intracardiac images created by the ViewMate II system help guide clinicians in performing procedures such as radiofrequency (RF) ablation to treat irregular heart rhythms, including atrial fibrillation (AF), and in closing defects such as patent foramen ovale (PFO), a small hole or opening in the wall between the two upper chambers of the heart (the atria). Clear views inside the heart also help reduce the time that it takes physicians to perform procedures, enabling patients to recover more quickly, enhancing hospital productivity.

The ViewMate II system with the ViewFlex Plus catheter recently received the European CE marking. The system also received the U.S. Food and Drug Administration (FDA) clearance in January 2008, and it has been used in the United States since that time. St. Jude Medical began marketing and distributing the ViewMate II system with ViewFlex Plus catheter following its merger with EP MedSystems, Inc. (West Berlin, NJ, USA) in July 2008.

Yaariv Khaykin, M.D., and Atul Verma, M.D., from Southlake Regional Health Center (Newmarket, Ontario, Canada), performed the first procedures using the ViewMate system outside the United States. "The ViewMate system provides images of improved contrast. Sharper, clearer images are critical to accurate diagnoses and precise treatments,” said Dr. Khaykin. Dr. Verma added, "The … system enables me to obtain images with greater depth, which in turn allows for more informed diagnoses and treatment decisions.”

The ViewFlex Plus catheter's one-hand control frees physicians to simultaneously position other devices with the other hand. Its tip features a 64-element, linear-phased array transducer capable of detailed, high-resolution imaging. The tip itself has a bidirectional curve and a deflection angle of up to 120^o, allowing it to capture images across broad areas of the heart. The catheter's 9 French size allows physicians to create a smaller opening through which to insert the catheter into a vessel, yet its design provides stability and control over viewing angles and positioning.

"The first use of the ViewMate II system outside the U.S. marks a significant milestone as we introduce products that help physicians around the world treat atrial arrhythmias, including AF [atrial fibrillation], a heart condition that affects millions of people and will grow in prevalence as populations age,” said Jane J. Song, president of the St. Jude Medical Atrial Fibrillation Division.

The ViewMate II ultrasound console is a complete digital cardiovascular imaging system. It provides transesophageal and transthoracic as well as intracardiac, imaging capabilities, and thus enables hospitals to maximize the value of their equipment investments. The console features on-screen menus and displays designed for intuitive operation by clinicians. Its monitor and keyboard are easily adjusted for comfortable viewing. Moreover, the console is able to store ultrasound digital images and files, allowing clinicians to gain quick access to them as needed.

The ViewMate II ultrasound console is manufactured by Philips Healthcare (Best, The Netherlands), a developer of ultrasound technology, and is based on the Philips HD11 XE platform. Under an agreement with Philips Healthcare, St. Jude Medical distributes the ViewMate II console as a stand-alone product and as part of the ViewMate II system.

St. Jude Medical develops medical technology and services that focus on putting more control into the hands of those who treat cardiac, neurologic, and chronic pain patients worldwide. The company has five major focus areas that include: cardiac rhythm management, atrial fibrillation, cardiac surgery, cardiology, and neuromodulation.

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