Stereotaxis technology (NIOBE®)

Hirslanden Clinic has one of the most modern technologies in Europe for the treatment of irregular heart rhythm at its disposal. These include the remote-control magnetic navigation system NIOBE® from the company Stereotaxis. Until recently, all catheters that are inserted through veins in the groin to be placed in the chambers of the heart could only be guided manually from the groin using guidewires.

The NIOBE® system now enables a computer to navigate the catheter. During treatment the patient lies between two large magnet coils which generate a magnetic field with its centre in the corresponding heart chamber. Small magnets are integrated in the tip of the extremely soft and flexible ablation catheter.

The clinic uses special software to view the catheter on the PC monitor and change the vector, i.e. re-align the magnetic field, to guide the catheter very accurately, to the millimetre, in the heart chamber. The operator no longer has to stand next to the patient, but sits in the control room which is separated by a pane of glass from the catheter laboratory. The electrophysiologist can advance and retract the catheter in the heart with a control module, all the other movements are achieved by changing the magnetic field.

This system can be used to treat atrial fibrillation, atrial flutter, Wolff-Parkinson-White syndrome and AV nodal reentry tachycardia. Hence the NIOBE® system is a novel catheter navigation system that offers a number of advantages: X-ray exposure is considerably reduced for doctor and patient alike. The computer-guided approach enables very accurate navigation. The strength of the magnetic field and the special properties of the flexible catheter ensure particularly good and stable contact between the catheter and the heart muscle. In addition, the catheters used are extremely soft and flexible to minimise trauma to the heart and blood vessel walls.

The clinician decides which patients are to be treated with the NIOBE® system and which are to be treated manually on a case to case basis. The decisive criteria here are not only the size of the atrium, secondary disorders and the patient’s condition, but also the individual course of the irregular heart rhythm.

However, the specialist’s experience still plays a vital role with this new technology in analysing and co-ordinating the information provided by the various systems (X-rays, stereotaxis, the mapping system (Carto, NavX) and the electrical signals).