25 April 2016
First paediatric cardiac centre in the UK to install integrated system
Young patients requiring therapeutic catheter ablation at
Bristol Royal Hospital for Children will benefit from a new
integrated system recently installed in the hospital's
catheterization laboratory.
Bristol children's hospital has become the first paediatric
cardiac centre in the UK, and the second paediatric centre in
Europe, Middle East and Africa to install the Biosense
WebsterCartoUnivusystem. When treating abnormal heart rhythms, it
is necessary to direct a catheter to the location that is causing
the abnormal heart rhythm. This has conventionally been done using
x-ray guidance; however this involves exposing the patient to small
doses of radiation. The newer CARTO, 3D mapping systems does not
require x-rays and works by using a magnetic catheter to create a
three-dimensional shell of the heart. The new CartoUnivusystem
works by combining these two features, so we get the benefit of
seeing an x-ray picture superimposed on a 3D picture of the heart,
without exposing the patient to radiation.
Mark Walsh, congenital cardiology consultant at Bristol
children's hospital said: "UniVu has really transformed how we
manage our electrophysiology cases. It permits better visualisation
of the heart by combining x-ray and the latest 3-D mapping
technology. This means that we can dramatically reduce the dose of
x-ray that a patient is exposed to.
"Another advantage with UniVu is that it provides us with an
advantage for difficult cases, for instance, especially when it
comes to imaging small blood vessel attached to the heart that
sometimes contains areas where the heart rhythm is abnormal."
Since the installation of the CartoUnivu model in January 2016,
Bristol children's hospital has successfully treated 25 paediatric
patients. The system has enabled cardiologists at the hospital to
treat conditions such Wolff-Parkinson-White syndrome which is a
common condition which has the potential to cause dangerous fast
heart rhythms and cardiac arrest in young children.
Rio Davies, age seven, was treated using the new integrated
system earlier this year. Rio's mother, Marcelle Davies said: "When
I was told Rio had suffered an out of hospital cardiac arrest
in France, I was shocked because what happened at the service
station had appeared similar to the seizure he had a few
years ago. I did not have any complaints earlier in the day
from him about him feeling unwell or uncomfortable.
"Despite doctor's best efforts at University Hospital Amiens in
France, to burn off the dangerous connection in Rio's heart, the
treatment was not successful and we flew back to the UK four weeks
later where he was treated by the paediatric cardiac team at
Bristol children's hospital. Rio immediately underwent an ablation
and made a quick recovery, returning to school and becoming his
usual energetic self. We then returned to the hospital earlier this
year, where Rio required a third procedure when Mr Walsh had
identified the connection had come back.
"With thanks to Mr Walsh and the team, Rio was successfully
operated on using the new equipment installed. Rio continues to be
seen routinely by the team and I am confident if the problem were
to occur again, Mr Walsh and the cardiac team will continue to
provide exceptional care."
Seven year old boy survives a cardiac arrest, and is
successfully treated with an emergency procedure at the Bristol
Royal Hospital for Children
Rio Davies, aged seven, was on his way home from Disneyland
Paris when he suffered an out of hospital cardiac arrest.
His mother, Marcelle Davies recalls the moment her son stopped
breathing: "We were getting on the coach following a stop at a
service station in France, on the way back from our holiday to
Disneyland Paris. As we got back on the bus Rio complained of a
belly ache and within moments of reaching our seats collapsed on
the floor. His body was rigid and he started fitting so I turned
him over and carried him off. It was following a second seizure
that he then stopped breathing in the car park.
"It was by chance that a man who replenishes the first aid boxes
at the services was there to give CPR. My friend was with me but I
was advised to move away from him when paramedics came. It took
three attempts with a defibrillator to get him back, after 10
minutes of not breathing."
Both Rio and Marcelle were taken to University Hospital Amiens
in France, where they both received treatment.
"I had collapsed from shock at the thought of losing my son,"
says Marcelle. "An ambulance took me to the emergency department
for treatment whilst Rio was taken by helicopter. Due to the
language barrier, the staff didn't realise I was with Rio, but
within an hour took me to ITU where he was being cared for."
Rio was diagnosed with a condition called Wolff-Parkinson-White
(WPW) syndrome; a relatively common condition in children. This
condition causes the heart to beat abnormally fast for periods of
time, caused by an extra bit of muscle that connects the top and
the bottom chambers of the heart. Rio had experienced a very rare
complication from WPW; a cardiac arrest. At eight years of age
patients are assessed to see whether they are at risk of this
complication. However, Rio had not undergone diagnostic testing as
he was only seven years of age at the time.
When Rio was stabilised he underwent a catheter ablation at
University Hospital Amiens. The procedure involves clinicians
placing small wires inside the heart and burning dangerous
connections with electricity.
Marcelle explains: "Following the ablation the team had
experienced some difficulties, but there was some initial success.
I couldn't fault the care Rio had received in France, they did all
they could but his condition did not improve so I requested we were
transferred to England. They agreed to move him, so that I could
get back to my other children and he could continue to receive care
for his condition closer to home. A private plane was organised to
fly us back to Bristol, with two doctors on board. He was
transferred by ambulance to Bristol children's hospital where he
was put into the care of the cardiac team.
"Mr Walsh carried out another cardiac ablation on the left side
of Rio's heart, weeks following his cardiac arrest in France. We
were in Bristol for four days before coming home to Merthyr
Tydfil.
"Rio continued to live life normally, returning to school.
We returned to Bristol children's hospital in January of this year
for a check-up, four months on from Rio's operation in
August. When asked how he was doing by Mr Walsh I responded
positively, expressing that Rio was his usual energetic
self. Despite him making good progress, his ECG showed a
change so Mr Walsh requested Rio stay in hospital to undergo a
third ablation. This time the team used a special
three-Dimensional mapping system which has proven successful.
He was transferred back to the hospital ward straight after the
procedure and discharged a couple of days later.
"It came as a surprise that Rio needed a third procedure but we
were fortunate Mr Walsh picked this up, and as a precaution we now
attend clinic every eight weeks.
"The care at Bristol children's hospital has been brilliant. I'm
aware Rio may need another procedure if this was to come back, but
I'm confident Mr Walsh and the cardiac team will continue to
provide exceptional care for him."
Further information on Wolff-Parkinson-White (WPW) syndrome can
be found here
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