Cutting edge computerised remote navigation technologies are enabling individuals with even the most complex of heart rhythm disorders to be treated safely and effectively at the Netcare Sunninghill Hospital Cardiac Centre in Johannesburg.
“At the hospital we are performing minimally invasive procedures to correct heart rhythm disorders which would previously have been impossible to treat thanks to technologies such as the Stereotaxis Niobe Remote Magnetic Navigation [RMN] system,” says Dr Anthony Stanley, an interventional cardiologist and heart rhythm specialist, or electrophysiologist, who practises at the hospital with fellow cardiologist and heart rhythm specialist, Dr Andrew Thornton.
“The RMN system, the only equipment of its kind in South Africa, is providing the interventional cardiologists at the hospital with the means to perform the most intricate procedures to correct complex heart rhythm disorders that would otherwise have been untreatable,” he adds.
According to Jacques du Plessis, managing director of the Netcare hospital division, the electrophysiology laboratory at Netcare Sunninghill Hospital “Is one of the best-equipped facilities of its kind in the country, offering patients a comprehensive heart rhythm disorder, or arrhythmia, service”.
Dr Stanley, an experienced interventional cardiologist who has been practising at Netcare Sunninghill Hospital’s well-known cardiac centre for 15 years, explains that the RMN system is a computerised magnetically-controlled navigation system that is used to remotely guide tiny surgical tools in minimally invasive heart rhythm disorder surgery.
“The technology utilises two permanent magnets mounted on pivoting arms that are enclosed within a stationary housing, with one magnet on either side of the patient table. These create a magnetic field that interacts with a tiny magnet in the tip of a catheter allowing finer navigation within the heart and arteries, and enabling us to control the interventional device with the highest degree of precision,” notes Dr Stanley.
“Used with CARTO mapping and sophisticated imaging systems, the RMN technology makes it possible for us to accurately navigate and control our surgical instruments no matter how many obstacles, such as scar tissue we have to go around, ‘corners’ we have to turn, or how far into the anatomic system we have to navigate. In other words, the RMN system provides us with the ability to safely access anatomic areas that are unreachable through standard approaches,” he emphasises.
These sophisticated technologies are enabling specialist electrophysiology teams under Dr Stanley and Dr Thornton at the hospital to perform, for example, successful heart rhythm correction procedures on patients who had undergone Mustard/Senning, arterial switch or other heart defect repair procedures as children.
“These patients, who earlier in life underwent life preserving surgery on the heart or heart vessels, typically soon after they were born, often go on to suffer heart rhythm disorders later in life,” he adds.
Dr Stanley, Dr Thornton and their team at the hospital recently performed a successful minimally invasive procedure using the RMN system on a 43-year-old patient from Johannesburg who had a Mustard procedure soon after his birth. The Mustard procedure was particularly widely used in the 1970s and 1980s to correct a life-threatening birth defect of the great arteries.
“As is quite common in such cases, the scar tissue from the old Mustard procedure had resulted in this patient developing a tachycardia, a heart rhythm disorder in which the heart beats abnormally fast, later in his life. The condition had become increasingly severe and the patient reported that he could not even climb a set of stairs without feeling breathless and exhausted,” says Dr Stanley.
“Thanks to the navigation system, without which we would not have been able to undertake this most delicate procedure, we were able to direct an ablation tool to destroy the scar tissue that was causing the electrical problem and correct it. The patient is delighted with the outcome of the procedure and reports that he has regained his strength and energy.”
Dr Stanley says that the magnetic navigation system enables the specialists to remotely control the catheter from a room adjacent to the patient, outside the x-ray fluoroscopy field, by simply moving a computer mouse. The system has the added advantage of assisting in reducing radiation exposure for physicians, theatre staff and patients.
According to Du Plessis, Netcare Sunninghill Hospital has become renowned for the adult and paediatric cardiac services it offers, which in addition to a heart rhythm service, include minimally invasive cardiology procedures such as angiography and stents, cardiothoracic surgery, vascular surgery, interventional radiology and transplantation.
All forms of arrhythmias can be diagnosed and treated at the hospital. Heart rhythm services include electrophysiology studies, cryo- and radio frequency-ablation, drug therapy and tilt testing. It also offers a pacemaker and ICD (implantable cardioverter defibrillator) service.
Ten adult cardiologists, three of whom super-specialise in arrhythmias, and five paediatric cardiologists now practise at Netcare Sunninghill Hospital. Dr Stanley and Dr Thornton were joined at the Netcare Sunninghill Hospital by a third electrophysiologist, Dr Kavashree Govender, at the beginning of September 2018, further strengthening this important cardiac sub-speciality at the facility.
“The use of advanced technology such as the stereotaxis navigation system, is an exciting development, as it brings hope to patients who were previously considered inoperable,” concludes Du Plessis.
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