New method of training of electrophysiologysts with human plastinated hearts

New method of training of electrophysiologysts with human plastinated hearts.

Maxim Didenko, MD PhD Dmitry Starchik, MD PhD Military Medical Academy, International Morphological Centre, Saint-Petersburg, Russia

Anatomia clavis et clavus medicine Анатомия есть ключ и руль медицины

Gabriele Fallopio

…Knowledge of normal and abnormal cardiac anatomy and electrophysiology…

Tracy et al.

AHA/ACP Clinical Competence Statement on Invasive Electrophysiology Studies, Catheter Ablation, and Cardioversion // JACC Vol. 48, No. 7, 2006:1503–17

Difficulties of electrophysiologysts education • Explanation of anatomy realize usually with pictures, schemes, slides, etc • Unfortunately using the fresh fixed hearts is very difficult and sometimes impossible • All methods of visualization in electrophysiological departments are indirect

Pictures, schemes, slides, etc

Clinical plastination New epoch in development of clinical medicine especially in cardiology (electrophysiology) Because: allows a better understanding of spatial anatomy, and explore new methods of treatment in hospital

Pulmonary veins ЛА

ВПВ ПВЛВ

ЛВЛВ

ЛНЛВ

ПНЛВ

RFA of PV

LIPV

Abl LAA CS

RFA AFL

HALO

TV Abl

RFA AP

CS

Abl

Triangle of Koch

SVC RAA

SVC

HIS

RSPV TV

FO The Koch triangle

CS IVC

TV CS IVC RV

RFA VT from LVOT

ABL ABL HIS HIS RV RV

12

Anatomy of Bachman’s bundle (BB) Ао

LA

BB SN SVC

RAA

pace

PA LA BB

SVC RAA SN pace FO

RA IVC

Anatomy of BB 3D CT

LA

SN SVC RAA

BB

LA BB

SVC

RAA

Ao

Positioning the atrial lead into the BB region (RAO)

10/26/09 

BB lead implantation

Positioning of select site into the RVS ÂŤSelect secureÂť

Anatomia.ru

Anatomy of cardiac veins

Anatomy of cardiac veins

Videodemonstration (lection): Anatomy for Electrophysiologysts

Training programs today train “ablationists” and “defibrillationists” (a.k.a. implanters), not electrophysiologists. “back to basics—learn electrophysiology” Josephson M., Electrophysiology at a Crossroads Heart Rhythm 2007;4:658–661

We need to understand (to explain) not only electrophysiology, but electrophysiology with anatomy This is the key for successful and safe treatment of arrhythmias

Back to basics — learn electrophysiology with anatomy in EP Lab

Conclusions: • Clinical plastination of the hearts provides variety of opportunities for education of fellows and widening clinical manner of thinking using natural plastinated specimens • Creating of plastinated specimens of a hearts can be defined as a new area of professional activity as it gives better understanding of spatial anatomy • Introduction of knowledge gained from clinical plastination will contribute further improvement quality of care