SEATTLE, July 20, 2004 - Swedish Heart Institute recently became home to cardiovascular medicine's latest technology - a new cardiac catheterization lab equipped with a state-of-the-art magnetic-assisted navigational device called the Niobe® System from St. Louis-based Stereotaxis Inc. Located at Swedish Medical Center/Providence Campus, it is designed to improve many catheter-based cardiac procedures, such as when using a catheter for evaluating irregular heartbeats, balloon angioplasty, and stent placement for treating blocked arteries.
It received approval from the U.S. Food and Drug Administration in January 2003. In May 2004, Swedish Heart Institute became the first program on the West Coast - and one of only 16 sites in the world - to begin using the system. To date, Swedish Heart Institute electrophysiologists and interventional cardiologists have used it in about 10 cases.
The majority of the $4 million price tag for Stereotaxis came from seed money from the State for development of the Seattle Heart and Vascular Institute - a collaborative effort among many of the region's cardiac-care providers, which will be located at Swedish/Providence.
The Stereotaxis system employs an arrangement of magnets that create a 360-degree magnetic field around the patient. Tiny magnets are placed at the tip of the catheters and guide wires, which are inserted into the arteries. The opposing magnetic field immediately surrounding the patient on the catheterization table is used to align the catheter's magnet, in much the same way the needle of a compass aligns with the North Pole. The physician then uses a joystick-type device to pinpoint the affected area and guide the catheter to the location. This new way of "steering" catheters differs from the more traditional method of manually twisting, turning and pushing the catheter through the arteries.
Greater precision, more flexibility (the catheter can make turns and twists of 90 degrees or sharper) and less dependence on physician dexterity are among the primary benefits this system offers over manual navigation.
The device is also designed to allow physicians the ability to access locations in the heart (not just vessels) that are difficult to reach and it is expected to make the cure of rhythms such as atrial fibrillation - the No. 1 arrhythmia cause for hospitalizations - more practical.
Previously, due to risks associated with their size or location, some arteries may have gone untreated or the patient may have become a candidate for open-heart surgery. It is hoped that because the magnetic force helps the physician to move the catheter into the desired treatment location, some patients may potentially be able to avoid surgery.
Although many interventional cardiology procedures are short in duration, at least 10 percent to 20 percent of them are prolonged due to navigation through difficult coronary arteries and the difficulty sometimes results in the inability to complete the procedure.
"It's reassuring to know that physicians who have used the system at other hospitals have reported the ability to perform procedures they potentially would not have been able to do without the device," says Swedish Heart Institute Interventional Cardiologist Mark Reisman, M.D., with Seattle Cardiac and Vascular Consultants. "And most have reported decreased procedure times, increased throughput, decreased costs and improved outcomes."
The system is expected to set a new standard of care for cardiovascular treatment within the next few years, but won't be exclusively for heart. "It can also be used for vascular and potentially neurovascular procedures," says Howard Lewis, M.D., executive director of the Swedish Heart Institute. "This system offers unique advantages. We expect the technology to grow in use and applications in the future."
In 2003, more than 4,200 cardiac catheterization procedures were performed between Swedish Medical Center's First Hill and Providence campuses. With this new technology, the Swedish Heart Institute expects to increase its ability to diagnose and treat patients with more complex coronary problems within King County and throughout Washington state.