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Patient care innovations

Liryc conducts many projects aimed at continuously improving and optimising the therapies available to treat heart rhythm disorders for the benefit of patients.

French No. 1 by volume of ablation procedures

Thermoablation of atrial fibrillation. In the 1990s, Liryc's clinicians identified the sources of atrial fibrillation in the pulmonary veins. This discovery helped to develop a curative treatment for this disorder. It involves cauterising the pulmonary veins with a radiofrequency catheter to isolate these sources of arrhythmia. This treatment has become the standard treatment: to date, more than 300,000 patients benefit from it each year worldwide.

Thermoablation of ventricular fibrillation. The clinicians also highlighted the sources of sudden death from ventricular fibrillation. These sources are located in the heart's electrical system, called the Purkinje network. This electrical network is essential for cardiac contraction and only represents 2% of the heart’s ventricular mass. Destruction of these sources of arrhythmia by thermoablation represents an innovative and curative approach to ventricular fibrillation in order to prevent sudden death.

The clinicians also practise cryotherapy ablation procedures in some cases of atrial fibrillation. 

Development of cardiac resynchronization therapy in heart failure

Other clinicians at Liryc have also been involved in the development of cardiac resynchronization therapy in heart failure. This electrical therapy involves implanting pacing leads in the ventricles. It aims to specifically correct electrical dyssynchrony in order to harmonise ventricular contraction and ensure better cardiac output.

Reference centre for implantation of the Micra© minimally invasive cardiac pacemaker

In 2014, Dr Philippe Ritter performed the first implantation on a patient in France of the smallest minimally invasive cardiac pacemaker in the world, called Micra® TPS. Nowadays, more than 100 patients have been implanted with the Micra® TPS at CHU de Bordeaux. Overall, CHU de Bordeaux performs around 800 pacemaker/defibrillator implantations per year, or the greatest number of procedures in France.

The minimally invasive pacemakers represent a significant advance in cardiac pacing. The innovative implantation technique and the device's size reduce the procedure time, as well as the patients’ recovery period.

The Micra® TPS is a device whose size is comparable to that of a large tablet or one-tenth of the size of a conventional cardiac pacemaker. It is implanted directly in the heart via a catheter introduced into the femoral vein. It is secured with small tines and delivers electrical impulses that regulate the heart rate by means of an electrode at the end of the device, therefore no longer requiring the use of leads to connect to the heart.

At the end of 2015, Philippe Ritter opened a training school “The Micra Academy” at Liryc in partnership with Medtronic. It aims to train French and European cardiologists in its optimal implantation

It is the French leader in remote monitoring

The remote monitoring of implantable cardiac prostheses started in France in 2001 after the implantation of the first remote-monitoring pacemaker in Bordeaux.

Data from the cardiac prosthesis are regularly sent by a remote transmitter in the patient’s home and analysed. This monitoring improves patient safety and optimises their follow-up.

CHU de Bordeaux, which was a pioneer in the field, is now a leader with an active list of more than 4,800 patients and the greatest number of procedures in France, all specialties combined.

Treatment of atrial fibrillation by ethanol infusion of the vein of Marshall 

Studies have shown that the ligament of Marshall may be the focus of electrical dysfunction. Therefore, it could constitute a major target in the treatment of atrial fibrillation, in addition to the pulmonary veins. However, conventional ablation techniques do not guarantee its complete destruction: indeed, it is generally isolated from radiofrequency currents by a sheath of adipose tissue. To counteract this technical limitation, the elimination of the ligament of Marshall and the surrounding lymph nodes can be achieved by injecting alcohol in the vein of Marshall which is adjacent to them.

This innovative technique has been proven to be both effective and safe.

State-of-the-art screening

Cardioinsight vest. The cardiology-electrophysiology and cardiac pacing department uses the Cardioinsight vest to improve ablation procedures.

It is an electrocardiogram mapping system with 252 non-invasive electrodes. This system combines electrical data collected on the body surface with 3D anatomical data to provide real-time, 3D images of the entire heart’s electrical activity in a single beat.

This jacket quickly identifies the arrhythmia regions and hence a greater speed and accuracy of ablation. 

2018 key figures from the electrophysiology and cardiac pacing department
  • 3,626 stays, including nearly 2% of international patients
  • 5,660 consultations
  • 2,282 procedures (interventional cardiology and cardiac surgical unit)