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Biosense noga system

Manufactured by Johnson & Johnson
Sourced in United States

The Biosense NOGA system is a laboratory equipment product designed for cardiac mapping and navigation. It enables the creation of 3D maps of the heart's electrical activity and anatomy. The system utilizes advanced sensor technology to gather real-time data, which can be used for various cardiac research and diagnostic applications.

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5 protocols using biosense noga system

1

Electro-Anatomical Mapping and Targeted Cell Delivery

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Electro‐anatomical mapping was performed using the Biosense NOGA system (Biosense‐Webster, Diamond Bar, CA) as previously described 13. For each patient, color‐coded unipolar voltage and linear shortening (LLS) maps and their corresponding 9‐segment “bull's‐eye” maps, consisting of at least 150 sampling points were generated. In accordance with previous studies in nonischemic DCM 14, 15, hibernating segments were defined as areas with average unipolar voltage ≥8.27 mV and average LLS <6%. Scarred myocardium was defined as areas with unipolar voltage <8.27 mV and LLS <6%, and normal myocardium was defined as areas with unipolar voltage ≥8.27 mV and LLS ≥6%. Local diastolic function was assessed off‐line by measuring local ventricular relaxation times at each of the sampling points (Fig. 2).
Target area for cell delivery was defined as the myocardial segments with unipolar voltage potentials ≥8.27 mV, and LLS <6% 13, 14. Transendocardial delivery of cell suspension was performed with MyoStar (Biosense Webster) injection catheter. Each patient received 20 injections of stem cell suspension (0.3 ml each).
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2

Electroanatomical Mapping for Stem Cell Therapy

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Electroanatomical mapping was performed using the Biosense NOGA system (Bio-sense-Webster, Diamond Bar, CA), which allows point-by-point analysis of left ventricular viability and local contractility. Using this technique, three-dimensional maps of color-coded myocardial viability (unipolar voltage [UV]) and regional myocardial contraction (local linear shortening [LLS]) and their corresponding 9-segment bull’s-eye maps, consisting of greater than or equal to 150 sampling points were generated for each patient before stem cell transplantation. In accordance with previous studies in NICM,16 (link) segments with electromechanical mismatch (EMM) were defined as areas with average UV greater than or equal to 8.27 mV and average LLS less than 6%, scarred myocardium was defined as areas with UV less than 8.27 mV and LLS less than 6%, and normal myocardium was defined as areas with UV greater than or equal to 8.27 mV and LLS greater than or equal to 6%. After completion of electroanatomical mapping, cells were injected in EMM target zones using the Myo-star catheter (Biosense-Webster) applying pre-specified criteria of UV greater than or equal to 8.27 mV and LLS less than 6%. Each patient received 20 injections of stem cell suspension (0.3 mL each).
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3

Electroanatomical Mapping for Stem Cell Therapy

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Electroanatomical mapping was performed using the Biosense NOGA system (Biosense‐Webster, Diamond Bar, California, https://www.biosensewebster.com). In short, electroanatomical mapping allows for point‐by‐point analysis of left ventricular viability and local contractility. Using this technique, maps of color‐coded myocardial viability (unipolar voltage; UV) and regional myocardial contraction (linear shortening) and their corresponding bull's‐eye maps, consisting of ≥150 sampling points, were generated for each patient prior to stem cell transplantation. Unipolar voltage was averaged for each of the 9 myocardial segments. Viability of the interventricular septum (IVS) was defined by averaging the measurements obtained in the septal and basal septal areas. In accordance with previous data on electroanatomical mapping in nonischemic DCM 11, transendocardial delivery of cell suspension was performed with MyoStar injection catheter targeting areas with unipolar voltage ≥8.27 mV and linear shortening <6%. Each patient received 20 injections of 0.3 ml.
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4

Stem Cell Delivery for Hibernating Myocardium

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Electroanatomical mapping is a procedure performed with the Biosense NOGA system (Biosense Webster, Diamond Bar, CA). This platform allows for point-by-point analysis of left ventricular viability and local contractility [21 (link)]. Using this technique, maps of color-coded myocardial viability (unipolar voltage, UV) and regional myocardial contraction (linear shortening, LLS) and their corresponding bull's-eye maps, consisting of ≥200 sampling points, were generated for each patient prior to stem cell transplantation. Hibernating myocardium was defined as areas with UV ≥ 8.3 mV and LLS<6%; myocardial scar was defined as segments with UV < 8.3 mV and LLS < 6% [2 (link), 3 (link), 22 (link)]. Transendocardial delivery of cell suspension was done using the MyoStar (Biosense Webster) injection catheter. Each patient received 20 injections of stem cell suspension, 0.3 mL of cell suspension per injection; all injections were performed within the areas of myocardial hibernation (UV ≥ 8.3 mV and LLS < 6%).
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5

Transendocardial Delivery of CD34+ Cells

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After stem cell collection, all patients underwent transendocardial injection of collected CD34+ cells. The procedure was performed using the Biosense NOGA system (Biosense Webster®, Diamond Bar, CA, USA). First, electroanatomic mapping of the left ventricle was performed. Points were acquired when the catheter tip was stable on the endocardium (defined as simultaneous stability of local activation time (LAT), location stability, loop stability, and cycle length stability). A map of the left ventricle was reconstructed with all endocardial regions adequately represented. For each patient, color-coded UV, local linear shortening (LLS), and their corresponding bull’s-eye maps, consisting of at least 200 sampling points, were generated. The target area for cell delivery was defined as areas with UV ≥8.3 mV and LLS <6%19
. Transendocardial delivery of cell suspension was performed with the MyoStar (Biosense Webster®) injection catheter. After acquiring a stable mapping point with the tip of the injection catheter perpendicular to the endocardial surface, the needle was advanced into the myocardium, and injections of cell suspension were performed. In the follow-up NOGA maps, any sampling points within the 3-mm radius of cell injection sites were defined as congruent points and were considered for the analysis.
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