View allAll Photos Tagged electrophysiologists
This year has been an odd one with my doing little photographic activity after a ''something' reduced my ability to carry my camera bag and distance.
However I went in, in early December, to be fixed by the electrophysiologist with his new procedure. It worked, hence this was my first time out with full camera bag for about least 6 months.
Now to return to the age old dialogue - what to photograph, where?
Sala de espera. Al electrofisiólogo para el interrogatorio del desfibrilador. Evidentemente me estoy sosteniendo. (Waiting room. At the electrophysiologist for the interrogation of my ICD. Evidently I’m still living.) 7 de septiembre, 2022. 3 1/2 x 11 in double page spread; watercolor, ink, whatever on moleskine soft cover notebook.
#newyorkmethodist #icd #waitingrooms #brooklyn
A bit sore and drowsy but survived and back in NSR (normal sinus rythmn) for the time being at least!
Procedure was scheduled for 12.00, eventually went down 3.20 (after the electrophysiologist had to come looking for me - how's that for personal service?) and came around from the anaesthetic about 6.30 - back on the ward and just had some lunch and will be able to move around again from 10.00 (and so starts the 3 month blanking period)
Thank you to everyone who sent good luck messages. It does mean a lot to me.
Al electrofisiólogo para un interrogatorio con desfibrilador. Sobre COVID, finalmente estoy mejorando. (To the electrophysiologist for defibrillator interrogation. Finally getting better from COVID.) 6 de junio, 2022.
7 1/2 x 15 in double page spread; watercolor, ink, whatever, on Stillman and Birn Zeta soft cover notebook.
#ftrain #subways #passengers #COVID
(Stephen with Kindle: en the office of the electrophysiologist: my electrician)
Blog: sharonfrost.tyepepad.com/day_books
7 x 14 in. double page spread; watercolor, ink, whatever, on paper.
TCAI electrophysiologists diagnose and treat cardiac arrhythmias through cardiac ablation and other techniques, allowing individuals to return to their lives with regular heart rhythm.
To learn more about Texas Cardiac Arrhythmia Institute please visit www.tcainstitute.com
Texas Cardiac Arrhythmia Institute electrophysiologists have access to the latest technology to treat heart rhythm disorders successfully. The Institute is one of a few worldwide with the Hansen Sensei Robotic surgical system and a state-of-the-art stereotaxis lab. Physicians use implantable devices such as pacemakers and defibrillators, remote internet-based patient monitoring, non-invasive diagnostics, 3D computer imaging, ultrasound, laser and radio frequency ablation.
To learn more about Texas Cardiac Arrhythmia Institute please visit www.tcainstitute.com
TCAI is pioneering a customized educational training program for visiting U.S. and non-U.S. physicians based on observational and in vivo training in hospitals. This program is designed to keep electrophysiologists and cardiologists up-to-date on the latest technologies and techniques for the treatment of cardiac arrhythmias.
To learn more about Texas Cardiac Arrhythmia Institute please visit www.tcainstitute.com
The use of robotic navigation for electrophysiology procedures is rapidly growing. These systems enhance the capabilities of our electrophysiologists during catheter placement by giving them a level of precision and stability that is simply unachievable by the unaided human hand. This technology helps shorten procedure times and improve success rates, while reducing radiation exposure and minimizing complications. It is particularly valuable for complicated arrhythmias.
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Imaging and robotic equipment within one of the four labs at TCAI.
To learn more about Texas Cardiac Arrhythmia Institute please visit www.tcainstitute.com
SpinaliS Smart series chairs for active sitting are voted number in the BEST CHAIR for aestheticians, estheticians, doctors and laboratory technicians categories. In addition to that we have received top scores in design, functionality and health benefits nominations. Thousands of users cannot be wrong!
This is what we still have in stock:
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Medical aestheticians, also known as clinical or paramedical aestheticians, are skincare specialists that work with cancer patients, burn victims and others with health-related issues. They treat and maintain facial skin that's been damaged because of fire, surgery, chemotherapy treatments and other incidents. Medical aestheticians are responsible for helping patients cleanse and moisturize their skin, as well as choose and apply the right makeup. Medical aestheticians work in hospitals, burn units, trauma centers, reconstructive surgery centers and other healthcare facilities.
Traditional estheticians, also known as skincare specialists, clean skin through skin exfoliation, massage, aromatherapy and facials. They also analyze skin for problems and temporarily remove hair. Estheticians may apply makeup and consult individuals on the best products for their skin type. Estheticians can be found in beauty salons, resorts, fitness clubs and spas.
There are different types of doctors, but these are the common ones that enjoy benefits of SpinaliS Smart series chairs for active sitting - addiction psychiatrists, adolescent medicine specialists, allergists, immunologists, anesthesiologists, cardiac electrophysiologists, cardiologists, cardiovascular surgeons, colon and rectal surgeons, critical care medicine specialists, dermatologists, developmental pediatricians, emergency medicine specialists, endocrinologists, family medicine physicians, forensic pathologist, gastroenterologist, geriatric medicine specialist, gynecologist, gynecologic oncologist, hand surgeon, hematologists, hepatologists, hospitalists, hospice and palliative medicine specialists, hyperbaric physicians, infectious disease specialists, internists, interventional cardiologists, medical examiners, medical geneticists, neonatologists, nephrologistm eurological surgeons, neurologists, nuclear medicine specialists, obstetricians, occupational medicine specialists, oncologists, ophthalmologists, oral surgeons, maxillofacial surgeons, orthopedic surgeons, otolaryngologist, ear, nose, and throat specialists, pain management specialists, pathologists, pediatricians, perinatologists, physiatrists, plastic surgeons, psychiatrists, pulmonologists, radiation oncologists, radiologists, reproductive endocrinologists, rheumatologists, sleep disorders specialists, spinal cord injury specialists, sports medicine specialists, surgeon, thoracic surgeons, urologists and vascular surgeons.
Order online at www.spinalis-chairs.ca/spinalis-chairs/ and we will deliver any of the SpinaliS chairs of your choice right to your door!
For more info call 844 777 0489
or drop by any of our three stores
SpinaliS Store in Vancouver, BC
3619 West 4th Ave
Vancouver, BC
V6R 1P2
SpinaliS Store in Victoria, BC
770 Spruce Avenue
Victoria, BC
V8T 5A5
SpinaliS Store in Kelowna, BC
ALIGNED CHIROPRACTIC
105-2041 Harvey Avenue
Kelowna, BC
V1Y 6G7
FREE Shipping Anywhere in Canada
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Medical Device
SpinaliS chairs were developed with a help of doctors and evaluated as a Class I medical device. Clinical evaluation of the medical device was processed by multiple clinics in Europe. However, in Canada, it is not possible to claim SpinaliS chairs to write your taxes off and they are not covered by any kind of medical insurance or health plan, yet.
Abs and Back Workout
Work out while sitting on any of the SpinaliS chairs and performing your daily tasks at the office or home.
Back Pain Relief
SpinaliS Chairs will work out your core muscles for you. Just sit, do your thing and leave everything else up to SpinaliS.
Stylish Office Chairs
Design of the SpinaliS Chairs is an eye candy â your customers will definitely notice them!
Yoga Ball Alternative
It is recommended not to sit longer than 2 hours on a yoga ball, but on the SpinaliS chairs you can sit all day long.
Standing Desk Alternative
SpinaliS chairs will actually make your body to work out and get you into a great shape without the hard task of standing or exercising.
Who does use SpinaliS?
Google, Dubai Airport, SONY, IBM, DELL, Skoda Auto, CSOB Bank, Unicredit Bank, Vodafone and many more.
SpinaliS Canada
ph: 778 989 0637
Chairs for Active Sitting to Eliminate Back Pain and Improve Posture - FREE SHIPPING in Canada
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Imaging technologies play a vital role in the treatment of cardiac arrhythmias, and the Texas Cardiac Arrhythmia Institute at St. David’s Medical Center (TCAI) has the most advanced technology available.
Our state-of-the-art imaging technologies include CartoSound integration, which combines real-time intracardiac echocardiography (ICE) imaging with robotic navigation, and DynaCT, which works with the Artis zeego system to provide high-resolution CT scans onsite within the electrophysiology laboratory suite.
To learn more visit www.tcainstitute.com
A cardiac ablation is one type of minimally-invasive treatment of arrhythmias. During the procedure, cells that are causing the heart to beat irregularly are destroyed using a catheter placed in specific locations inside the heart. As a pre-curser to treating the arrhythmia, physicians create an electrical road map of the heart to help guide the placement of the ablation catheter. This road map is created by placing a mapping catheter to record electrical signals from various locations in the heart.
The most important element in mapping and ablation is placing the catheter in the correct location to create an accurate map, ensuring that only abnormal tissue is destroyed. The Hansen Sensei Robotic surgical system provides the Institute’s electrophysiologists with more precise control during these procedures.
TCAI electrophysiologists have achieved worldwide renown for their efforts in advancing the level of care through research and technology. They travel throughout the world, leading and attending conferences, pioneering innovative techniques, and influencing the future of the field.
To learn more about the TCAI Team please visit www.tcainstitute.com/our-team/our-team.aspx
The use of robotic navigation for electrophysiology procedures is rapidly growing. These systems enhance the capabilities of our electrophysiologists during catheter placement by giving them a level of precision and stability that is simply unachievable by the unaided human hand. This technology helps shorten procedure times and improve success rates, while reducing radiation exposure and minimizing complications. It is particularly valuable for complicated arrhythmias.
To learn more about robotic navigation at TCAI please visit www.tcainstitute.com/our-technology/robotics-navigation.aspx
To learn more about robotic navigation please visit www.tcainstitute.com/our-technology/robotics-navigation.aspx
Here's a screenshot of an article I have had published in the December, 2014 issue of EP Lab Digest. It involves a personal perspective of participating in endurance sports while in permanent atrial fibrillation. I guess I'm "tooting my own horn" here today.
afibrunner.com/2014/12/07/afibrunner-patient-perspectives...
Texas Cardiac Arrhythmia Institute combines leading edge robotics, advanced mapping systems and advanced imaging technologies to give patients unique access to the very latest treatment options
On Oct 2, Destin Area Chamber of Commerce ambassadors and staff gathered to celebrate Okaloosa Heart & Vascular Center’s new Destin office with a ribbon cutting.
Okaloosa Heart & Vascular Center provides current, comprehensive healthcare in the diagnosis, prevention, and treatment of heart problems. It offers clinical cardiology and consultation, echocardiography, vascular ultrasound, exercise testing, holter and event monitoring, nuclear cardiac imaging, cardiac catheterization, coronary angioplasty, intra-coronary stenting, electrophysiology specializing in heart rhythm disorders, and endovascular surgery.
“With five interventional cardiologists, one electrophysiologist, two endovascular surgeons, and five local offices to serve you, the staff is committed to exploring new technologies and techniques that provide better ways to care for their patients and to treating each patient like a person rather than a diagnosis,” explained business manager Barbara Sierra. The practice was established in 1991.
Its doctors include Mark J. Katzenstein, MD, FACC, FSCAI; Joseph A. Pedone, MD, FACC, FACP, FSCAI; Michael L. Yandel, MD, FACC, FSCAI; Juan C. Zarate, MD, FACC, FSCAI; Anthony S. Al-Dehneh, DO, FACC; S. Mark Borganelli, MD, FACC; Marcello A. Borzatta, MD, FACS; and Emilio C. Calabrese, MD, FACS.
For more information, visit the new office at 36468 Emerald Coast Parkway, in Destin’s Old South Centre. You may also call (850) 424-5638 or visit OkaloosaHeart.com.
Dr. Stephan Schuele (right) leads the Northwestern University Comprehensive Epilepsy Center based at Northwestern Memorial Hospital. The center's team of neurologists, neurosurgeons, radiologists, neuropsychologists, electrophysiologists, and nuclear medicine specialists apply the latest advances in molecular biology, imaging, and pharmacology to diagnose and treat epilepsy.
200429-N-DA693-1278
LOS ANGELES (April 29, 2020) Cmdr. Andrew Kaplan (left), a cardiac electrophysiologist from Phoenix, and Hospital Corpsman 1st Class Amelia Ibrahim, a surgical technologist from West Palm Beach, Fla., suture a patient aboard the hospital ship USNS Mercy (T-AH 19) April 29. Mercy deployed in support of the nation's COVID-19 response efforts, and serves as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals. This allows shore base hospitals to focus their efforts on COVID-19 cases. One of the Department of Defense's missions is Defense Support of Civil Authorities. DoD is supporting the Federal Emergency Management Agency, the lead federal agency, as well as state, local and public health authorities in helping protect the health and safety of the American people. (U.S. Navy photo by Mass Communication Specialist 3rd Class Jake Greenberg)
200429-N-DA693-1103
LOS ANGELES (April 29, 2020) Hospital Corpsman 1st Class John Ancell (left), a surgical technologist from Surprise, Ariz., assists Cmdr. Andrew Kaplan, a cardiac electrophysiologist from Phoenix, adjust his surgical head lamp aboard the hospital ship USNS Mercy (T-AH 19) April 29. Mercy deployed in support of the nation's COVID-19 response efforts, and serves as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals. This allows shore base hospitals to focus their efforts on COVID-19 cases. One of the Department of Defense's missions is Defense Support of Civil Authorities. DoD is supporting the Federal Emergency Management Agency, the lead federal agency, as well as state, local and public health authorities in helping protect the health and safety of the American people. (U.S. Navy photo by Mass Communication Specialist 3rd Class Jake Greenberg)
200429-N-DA693-1141
LOS ANGELES (April 29, 2020) Cmdr. Andrew Kaplan, a cardiac electrophysiologist from Phoenix, sutures a patient aboard the hospital ship USNS Mercy (T-AH 19) April 29. Mercy deployed in support of the nation's COVID-19 response efforts, and serves as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals. This allows shore base hospitals to focus their efforts on COVID-19 cases. One of the Department of Defense's missions is Defense Support of Civil Authorities. DoD is supporting the Federal Emergency Management Agency, the lead federal agency, as well as state, local and public health authorities in helping protect the health and safety of the American people. (U.S. Navy photo by Mass Communication Specialist 3rd Class Jake Greenberg)
200429-N-DA693-1239
LOS ANGELES (April 29, 2020) Cmdr. Andrew Kaplan, a cardiac electrophysiologist from Phoenix, sutures a patient aboard the hospital ship USNS Mercy (T-AH 19) April 29. Mercy deployed in support of the nation's COVID-19 response efforts, and serves as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals. This allows shore base hospitals to focus their efforts on COVID-19 cases. One of the Department of Defense's missions is Defense Support of Civil Authorities. DoD is supporting the Federal Emergency Management Agency, the lead federal agency, as well as state, local and public health authorities in helping protect the health and safety of the American people. (U.S. Navy photo by Mass Communication Specialist 3rd Class Jake Greenberg)
200429-N-DA693-1194
LOS ANGELES (April 29, 2020) Cmdr. Andrew Kaplan, a cardiac electrophysiologist from Phoenix, sutures a patient aboard the hospital ship USNS Mercy (T-AH 19) April 29. Mercy deployed in support of the nation's COVID-19 response efforts, and serves as a referral hospital for non-COVID-19 patients currently admitted to shore-based hospitals. This allows shore base hospitals to focus their efforts on COVID-19 cases. One of the Department of Defense's missions is Defense Support of Civil Authorities. DoD is supporting the Federal Emergency Management Agency, the lead federal agency, as well as state, local and public health authorities in helping protect the health and safety of the American people. (U.S. Navy photo by Mass Communication Specialist 3rd Class Jake Greenberg)
Dr. David Birnie, Staff Cardiac Electrophysiologist and Director of the Arrhythmia Service, Ottawa Heart Institute
final week of ambulance work. today we waltzed into high
holiday synagogue services and extracted this very old guy who
"fainted." waves of jews parted to make way for the messiah-like team
of ambulance technicians, while others kept right on bobbing and
mumbling prayers. I've decided I like prehospital care because it
satisfies my voyeuristic instincts, I mean we just marched right into
this temple like we owned the place, didn't even put on yarmulkes.
anyway his rhythm strip is bizarre, any electrophysiologists out
there feel free to offer your interpretation.
after that we assumed our roles as public service workers in the
field and went to krispy kreme for coffee and doughnuts. I had one
glazed doughnut and one cream-filled donut with chocolate icing. two
doughnuts, and my tuesday was ruined. I felt horrible all day, like
my stomach was a kid being dragged someplace he didn't want to go.
just now, at one in the morning, do I feel like eating again.
1. what has happened to me. I used to consume a dozen doughnuts in one sitting.
2. it's unclear whether ruining an entire day is an acceptable
consequence of consuming two krispy kreme doughnuts. perhaps if
you're going to ruin the day you should have three or four. holy
shit are those good doughnuts.
..to biannual interrogration. Can it be the shirt from Las Martirio (flamenco bar in Ronda Andalucía)
Central Ohio Podcasters Meeting
I had a big day.
Today was my Echocardiogram and Stress Test. The Echo was weird; seeing my own heart! The Stress Test lived up to it's name. The tech saw a couple PVCs as I was cooling down but not as I was doing the test. The cardiologist called me about two hours after the tests to tell me my Echo looked good and my Stress Test was "perfect". He went on to say I still have the highest PVC count he has ever seen (8,699 (362/hr) isolated PVCs in 24 hours) and he would ask some electrophysiologists if further testing is needed.
After my testing I met TC at Donerick's on Henderson for a couple drinks before the Central Ohio Podcasters meeting. He was freely talking to anybody in the bar and asking them to check out the Podcast.
The podcast meeting was weird. The topic tonight was "monetizing your podcast". TC and I were a little lit and he blurted out in the middle of the presentation a tirade of getting pressured to do video. TOTALLY off topic. He would go on to blurt out all sorts of things for the remainder of the meeting. It was awkward. At least they provided pizza.
March 28, 2017 weight: 159.1 lbs (Garmin) (158.8 lbs Tanita)
March 28, 2016 weight: 171.7 lbs (Garmin)
This is the tip of an RF ablation catheter which is used to correct abnormal heart rhythms. Examples of rhythms that it can correct are atrial flutter, atrial fibrillation, AVNRT, etc. An electrophysiologist (cardiologist who specializes in the electrical conduction of the heart) will insert these catheters and many others at the same time into a patient's veins and guided into their heart using fluoroscopy (video x-rays). They can then use these wires and sensors to measure the electrical signals being conducted in the heart in order to find the area that is producing the abnormal heart signals. Some arrhythmias are caused by loops in the heart that can be corrected by breaking the loop. Once identified, these abberant areas can then be ablated or destroyed via burning with increased temperature in this case. Other types of catheters which are not pictured here may use liquid nitrogen balloons to burn via decreased temperature / freezing instead. This results in breaking the loop that produces the abnormal heart signals, thereby fixing the heart rhythm.
The design of this ablation catheter is very complex and is jam packed into a tube only 8 Fr or 2.667mm in diameter. This model is the TactiFlex™ Sensor Enabled™ Ablation Catheter from the medical device company, Abbott. It has a few interesting features: electromagnetic sensing of the tip position with an associated computer guidance system using other electrode sensors, an integrated force sensor, a flexible metal tip, integrated fluid irrigation to reduce / control the tip's temperature so that other structures are less likely to be damaged accidentally, and three more integrated electrodes. It also has knob that the doctor can twist to bidirectionally articulate the tip of the catheter.
#1 Computer software allows creation of a realtime 3D map of the ablation catheter's position in relation to the other catheters and what voltages / cardiac signals it is picking up. This allows mapping of areas such as the CTI or cavotricuspid isthmus in the right atrium where atrial flutter (a cardiac arrhthmia) most commonly originates. Other areas include the pulmonary veins as a source for atrial fibrillation, and around the AV node & bundle of HIS for AVNRT (atrioventricular nodal reentry tachycardia).
#2 The force sensor in this catheter is especially cool in design. It uses a simple concept from quantum mechanics: the wave property of light to achieve miniscule measurements on the order of nanometers or less. The tip of the catheter houses a tiny titanium structure containing mirrors that deflects very slightly with application of force. This can be measured using lasers that create an interference pattern caused by overlapping light waves. This is known as a technique called Fabry–Pérot interferometry and light interferometry. This allows the doctor to ensure good contact with the tissue that they wish to burn by applying the appropriate force as they cannot visualize any of what the tip of the catheter is doing directly. This is in conjunction to ultrasound imaging, x-ray fluoroscopy, and the electromagnetic sensing maps created.
#3 The newly designed metal tip is laser cut to have a specific pattern that allows for flexion and acts as a spring to provide better tissue contact.
#4 This catheter is an RF or radiofrequency catheter. It produces high power radio waves of electrical energy that radiate out of its tip. The frequencies typically used are in the hundreds of kilohertz (kHz). This allows for localized heating of nearby tissue that absorb this concentrated radio energy similar in idea to a microwave but with lower frequency waves. The tip itself should remain cool to avoid damaging other unintended structures when being moved after ablating a certain location in the heart. This is measured from a thermocouple near the catheter tip. The tip also should remain cool to prevent boiling of the blood which could lead to a "steam pop". This may lead to production of gas within the circulatory system which could be dangerous to the patient if it is produced in sufficient quantities. If the gas bubble is near enough to sensitive structures such as capillaries or arterioles, it could form an air embolus that blocks normal blood flow to a structure in the body. To prevent these complications and reduce risk, the pictured catheter uses fluid that flows out of holes in tip to cool itself.
www.cardiovascular.abbott/int/en/hcp/products/electrophys...
www.cardiovascular.abbott/int/en/hcp/products/electrophys...
www.cardiovascular.abbott/int/en/hcp/products/electrophys...
This photo is in 3D crossview. You cross your eyes while keeping the screen centered and it should become one image at the center in 3D. More Instructions for viewing 3D images: www.3dphoto.net/text/viewing/technique.html
Stereo Viewer for all my photos: jongames.com/stereophoto/
Off-pump Coronary artery bypass graft (OPCABG) to Anterior Descending with internal mammary artery.
Learn more about Heart Condition by best ELECTROPHYSIOLOGIST In London UK - Dr Boon Lim(drboonlim.co.uk/)
Source:(www.instagram.com/p/B6oOz84JRWZ/)
Dayton cardiology consultants offer these general services:
New Independent Interventional Cardiologist/Electrophysiologist located in Centerville and Middletown Ohio
Appointment available within 48 hrs
Outpatient cardiac testing available and affordable vs cardiac testing done at the hospital
Cardiac Concerns: Atrial fibrillation – Arrhythmia – Heart Failure -
Cardiac testing – Lexiscan Nuclear Stress Test- Graded Exercise Test, 2D Echo, Carotid Ultrasound, Renal Ultrasound, Abdominal Ultrasound, Venous Duplex for DVT, Arterial Duplex- 24-48 hour Holter Monitor – Event Monitor - EKG
Specializing in Implanted Devices – Pacemaker, Biventricular Pacemaker, AICD, Loop Recorder
Cardiac Procedures – Cardiac Ablation- Cardiac Catherization
Local Hospital Rounding at– Miami Valley Hospital - Miami Valley Hospital South – Atrium Medical Center – Kettering Medical Center
For to know more about Dayton Cardiology and Vascular Consultants visit website by clicking the following link Dayton cardiologists
Clinical Cardiac Electrophysiologist, Dr. Kishore Subnani joins the McLeod Cardiology Associates team serving the Horry and Brunswick County areas.
Dr. Subnani received his medical degree at American University of the Caribbean in Coral Gables, Florida.
Dr. Subnani completed his medical residency as well as completion of his Clinical Cardiovascular fellowship at SUNY Downstate Medical Center in Brooklyn, New York.
Choosing to further his career in Cardiology and Electrophysiology, Dr. Subnani attended NYU Langone Medical Center in New York, New York, completing his fellowship in Clinical Cardiac Electrophysiology.
Dr. Subnani is board certified in Cardiovascular Disease, Internal Medicine and Clinical Cardiac Electrophysiology.
Board Certifications: Clinical Cardiac Cardiovascular Disease, Electrophysiology, Internal Medicine
Medical School: American University of the Caribbean, Coral Gables, FL/2009
Residency: SUNY Downstate Medical Center in Brooklyn, NY/2012
Fellowships: Clinical Cardiac Cardiovascular - SUNY Downstate Medical Center in Brooklyn, NY/2015
Clinical Cardiac Electrophysiology - NYU Langone Medical Center in New York, NY/2017
Today was my first day of work in Thousand Oaks, CA. Amgen is the World's largest biotechnology company by annual sales. I have joined their lead discovery group as an electrophysiologist. It will be quite a change and I have mixed feelings about moving away from the bay area - my home since 1990.
One thing for sure is exciting days ahead for the Amagasus. We will be living close to my in-laws and will be doing lots of drug discovery research.
This is the tip of an RF ablation catheter which is used to correct abnormal heart rhythms. Examples of rhythms that it can correct are atrial flutter, atrial fibrillation, AVNRT, etc. An electrophysiologist (cardiologist who specializes in the electrical conduction of the heart) will insert these catheters and many others at the same time into a patient's veins and guided into their heart using fluoroscopy (video x-rays). They can then use these wires and sensors to measure the electrical signals being conducted in the heart in order to find the area that is producing the abnormal heart signals. Some arrhythmias are caused by loops in the heart that can be corrected by breaking the loop. Once identified, these abberant areas can then be ablated or destroyed via burning with increased temperature in this case. Other types of catheters which are not pictured here may use liquid nitrogen balloons to burn via decreased temperature / freezing instead. This results in breaking the loop that produces the abnormal heart signals, thereby fixing the heart rhythm.
The design of this ablation catheter is very complex and is jam packed into a tube only 8 Fr or 2.667mm in diameter. This model is the TactiFlex™ Sensor Enabled™ Ablation Catheter from the medical device company, Abbott. It has a few interesting features: electromagnetic sensing of the tip position with an associated computer guidance system using other electrode sensors, an integrated force sensor, a flexible metal tip, integrated fluid irrigation to reduce / control the tip's temperature so that other structures are less likely to be damaged accidentally, and three more integrated electrodes. It also has knob that the doctor can twist to bidirectionally articulate the tip of the catheter.
#1 Computer software allows creation of a realtime 3D map of the ablation catheter's position in relation to the other catheters and what voltages / cardiac signals it is picking up. This allows mapping of areas such as the CTI or cavotricuspid isthmus in the right atrium where atrial flutter (a cardiac arrhthmia) most commonly originates. Other areas include the pulmonary veins as a source for atrial fibrillation, and around the AV node & bundle of HIS for AVNRT (atrioventricular nodal reentry tachycardia).
#2 The force sensor in this catheter is especially cool in design. It uses a simple concept from quantum mechanics: the wave property of light to achieve miniscule measurements on the order of nanometers or less. The tip of the catheter houses a tiny titanium structure containing mirrors that deflects very slightly with application of force. This can be measured using lasers that create an interference pattern caused by overlapping light waves. This is known as a technique called Fabry–Pérot interferometry and light interferometry. This allows the doctor to ensure good contact with the tissue that they wish to burn by applying the appropriate force as they cannot visualize any of what the tip of the catheter is doing directly. This is in conjunction to ultrasound imaging, x-ray fluoroscopy, and the electromagnetic sensing maps created.
#3 The newly designed metal tip is laser cut to have a specific pattern that allows for flexion and acts as a spring to provide better tissue contact.
#4 This catheter is an RF or radiofrequency catheter. It produces high power radio waves of electrical energy that radiate out of its tip. The frequencies typically used are in the hundreds of kilohertz (kHz). This allows for localized heating of nearby tissue that absorb this concentrated radio energy similar in idea to a microwave but with lower frequency waves. The tip itself should remain cool to avoid damaging other unintended structures when being moved after ablating a certain location in the heart. This is measured from a thermocouple near the catheter tip. The tip also should remain cool to prevent boiling of the blood which could lead to a "steam pop". This may lead to production of gas within the circulatory system which could be dangerous to the patient if it is produced in sufficient quantities. If the gas bubble is near enough to sensitive structures such as capillaries or arterioles, it could form an air embolus that blocks normal blood flow to a structure in the body. To prevent these complications and reduce risk, the pictured catheter uses fluid that flows out of holes in tip to cool itself.
www.cardiovascular.abbott/int/en/hcp/products/electrophys...
www.cardiovascular.abbott/int/en/hcp/products/electrophys...
www.cardiovascular.abbott/int/en/hcp/products/electrophys...
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Stereo Viewer for all my photos: jongames.com/stereophoto/
This is the electrophysiologist at UMC. He is a cardiology specialist who deals with abnormal heart rhythms. He is the nicest guy and also a cowboy. He comes twice a year to herd cattle and help brand.
Nine-year-old Sophia Dahlberg went to the emergency room when her abnormal heart rhythm condition worsened. In the ER, her cardiologist suggested a corrective heart procedure using a new tool.
Sophia is one of the first beneficiaries of new heart mapping technology available at Dell Children’s Medical Center of Central Texas, called Abbott EnSite Precision™ cardiac mapping system.
The technology collects high-resolution data much faster than before. According to Daniel Scmorhun, MD, Dell Children’s pediatric electrophysiologist, the new tool cuts the exposure time in half, which may also significantly reduce the amount of radiation exposure.
Just one week after the procedure, Sofia jumped back into her full activity and is doing great.
Dell Children’s is the first pediatric facility in Texas and the third in the U.S. to install the cardiac mapping system, approved by the U.S. Food & Drug Administration in December 2016.
SVT is a common abnormality you will encounter in training. It is commonly associated with a rentrant loop (large “macro” or small “micro”) that allows rapid conduction from the atrium to the ventricle. .
Most commonly SVTs are narrow complex regular tachycardia. The most common SVT is sinus tachycardia! When most people think of SVTs they think of AVNRT (Short RP tachycardia) and AVRT (wolf Parkinson’s white syndrome).
SVTs are managed by recognizing the rhythm on a 12 lead EKG with a narrow complex tachycardia (usually with rates >150 bpm). SVTs more commonly occur in people with structural normal hearts (however not always true i.e congenital heart disease) and are often treated with AV nodal blockers like beta blockers, CCBs, and adenosine. SVTs are very treatable with procedures called ablations so don’t be afraid to consult your neighborhood Electrophysiologists! .
drboonlim.co.uk/supraventricular-tachycardia-svt/
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