2024 Outcomes - Baylor Scott & White Heart and Vascular Hospital Fiscal year 2024 | Page 61

• Pacemaker implantation – Advanced technologies include MRI scan compatible devices , cellular network home monitoring with wireless communication and the catheter-delivered leadless pacemaker
• ICD implantation – Offering MRI scan compatibility , cellular network home monitoring with wireless communication and subcutaneous ICD
• Cardiac resynchronization therapy ( CRT ) or biventricular pacing – Particularly helpful for advanced heart failure patients , CRT sends small electrical impulses to the heart muscle to allow the ventricles to contract together , which may improve cardiac function
• Left atrial appendage closure devices
• Laser lead extraction
• Ablation – Offering a variety of ablation techniques including pulsed field ablation , radiofrequency or cryo-energy ablation , which converts abnormal heart electrical tissue to scar tissue and corrects abnormal circuits : The use of advanced mapping systems for signal analysis by the EP specialists results in a greater degree of precise identification of the abnormal rhythm circuit for ablation cases .
• MRI compatible ICDs are routinely used , allowing patients and their physicians to employ this modality for diagnostic imaging even after ICD implantation .
• Available CRT devices provide multipoint pacing , a “ next generation ” form of CRT that paces the ventricles from three sites instead of two . This form of pacing has been shown to increase the clinical response rate of heart failure patients in early clinical trials .
• Treatment options include leadless pacemakers that are implanted using femoral access and are entirely contained within the heart itself . Leadless pacemakers also includes a dual chamber option .

Cardiac Electrophysiology

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The electrophysiology program on the Fort Worth campus offers expertise in treating all types of heart rhythm disorders from atrial fibrillation to ventricular tachycardia .
Specialized interventions

• Pacemaker implantation – Advanced technologies include MRI scan compatible devices , cellular network home monitoring with wireless communication and the catheter-delivered leadless pacemaker

• ICD implantation – Offering MRI scan compatibility , cellular network home monitoring with wireless communication and subcutaneous ICD

• Cardiac resynchronization therapy ( CRT ) or biventricular pacing – Particularly helpful for advanced heart failure patients , CRT sends small electrical impulses to the heart muscle to allow the ventricles to contract together , which may improve cardiac function

• Left atrial appendage closure devices

• Laser lead extraction

• Ablation – Offering a variety of ablation techniques including pulsed field ablation , radiofrequency or cryo-energy ablation , which converts abnormal heart electrical tissue to scar tissue and corrects abnormal circuits : The use of advanced mapping systems for signal analysis by the EP specialists results in a greater degree of precise identification of the abnormal rhythm circuit for ablation cases .

Pacing and defibrillation
Baylor Scott & White Heart and Vascular Hospital – Fort Worth experienced a strong volume of implantable cardioverter defibrillators ( ICDs ) and cardiac resynchronization therapy ( CRT ). Benefits of these devices include :

• MRI compatible ICDs are routinely used , allowing patients and their physicians to employ this modality for diagnostic imaging even after ICD implantation .

• Available CRT devices provide multipoint pacing , a “ next generation ” form of CRT that paces the ventricles from three sites instead of two . This form of pacing has been shown to increase the clinical response rate of heart failure patients in early clinical trials .

• Treatment options include leadless pacemakers that are implanted using femoral access and are entirely contained within the heart itself . Leadless pacemakers also includes a dual chamber option .

Celebrating “ firsts ” in the area
In November 2023 , the first Aurora extravascular implantable cardiac defibrillator ( EV-ICD™ ) system in Texas was implanted by a team at Baylor Scott & White Heart and Vascular Hospital – Fort Worth . The system is designed to treat dangerously fast heart rhythms that can lead to sudden cardiac arrest , while avoiding certain risks of
Aleem Mughal , MD , FHRS - Medical Director , Electrophysiology traditional , transvenous ICDs because its lead is placed outside the heart and veins , under the breastbone using a minimally invasive approach . The clinical team at Baylor Scott & White Heart and Vascular Hospital – Fort Worth , led by Aleem Mughal , MD , FHRS , medical director of electrophysiology , and Anita Krueger , MD , FACS , medical director of the ECMO team , implanted the EV-ICD system in the patient who was diagnosed with tachycardia . The Aurora system was positioned under his left armpit with a thin lead wire placed just under his sternum , outside of his heart and veins , to deliver a rhythmregulating shock if needed . Because the lead was placed close to the heart , the energy required for pacing and defibrillation was lower than if it were further away and separated from the heart by bone .
YEAR IN REVIEW
FY24

> 1,200

EP cases

> 400

Pacemakers / ICD implanted

231

Afib ablations

103

SVT ablations

12

VT ablations

70

ILR
Baylor Scott & White Heart and Vascular Hospital — Fort Worth | Cardiac Electrophysiology