Catheter Ablation Utilizing Remote Magnetic Navigation: A Review of Applications and Outcomes

Bradfield, Jason S.; Tung, Roderick; Mandapati, Ravi; Boyle, Noel G.; Shivkumar, Kalyanam

doi:10.1111/j.1540-8159.2012.03382.x

Cited by 70 publications

(79 citation statements)

References 41 publications

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“…3 The main advantages of RMN-guided catheter ablation are precision, flexible navigation, reduced fluoroscopy time, and an excellent safety profile. 4 RMN-guided AF ablation procedures seem to be associated with fewer peri-procedural complications when compared to manually guided procedures. 5 However, previous studies regarding RMN-guided AF ablation have been limited in terms of sample size.…”

Section: Introductionmentioning

confidence: 91%

Efficacy and Safety of Atrial Fibrillation Ablation Using Remote Magnetic Navigation: Experience from 1,006 Procedures

Pehrson

Jacobsen

et al. 2016

Cardiovasc electrophysiol

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RMN-Guided Ablation for AF. Background:The objective of this study was to assess the procedural outcomes of catheter ablation guided by remote magnetic navigation (RMN) in a large cohort of patients with paroxysmal atrial fibrillation (PAF) and persistent AF (PerAF).Methods: A total of 726 patients (547 male, age: 58.5 ± 10.3 years) with symptomatic AF (61% PAF) were analyzed from a prospective ablation registry. Procedural parameters including pulmonary venous (PV) anatomy, left atrial (LA) volume, procedural time, ablation time, fluoroscopy time, total X-ray dose, and complications were assessed.Results: One thousand and six ablation procedures were analyzed. One-third of the patients (240/726) were ablated on more than one occasion, resulting in a mean of 1.3 ± 0.6 times for the entire group. When analyzing all procedures, the mean procedural time and ablation time was 134 ± 35 minutes and 2,130 ± 1,025 seconds, respectively. The mean fluoroscopy time was 5.4 ± 3.7 minutes. Compared to PAF patients, procedural time and ablation time were significantly increased in patients with PerAF by 10% (P < 0.001) and 19% (P < 0.001), respectively. However, fluoroscopy time was not increased (5.3 ± 3.5 minutes, PAF vs. 5.6 ± 4.0 minutes, PerAF, P = 0.17). The overall complication rate was 0.6%. One PAF patient experienced cardiac tamponade. AF repeat ablations by RMN significantly reduced the procedural and ablation times when compared with their first ablation times.Conclusions: AF ablation guided by RMN is safe as evidenced by a low complication rate. Fluoroscopy time was relatively short for both PAF and PerAF

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Section: Introductionmentioning

confidence: 91%

Efficacy and Safety of Atrial Fibrillation Ablation Using Remote Magnetic Navigation: Experience from 1,006 Procedures

Pehrson

Jacobsen

et al. 2016

Cardiovasc electrophysiol

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“…[26][27][28][29][32][33][34][35][36][37][38][39][40][41] It also has safety advantages with a lower risk of cardiac perforation due to the compliant nature of catheter and lower fluoroscopy exposure. Moreover, in patients with distorted anatomy or extensively dilated cardiac chamber, due to the magnetic ablation catheter being steered via the distal tip, it facilitates reaching all areas, thereby increasing sequential 3D 46 Wu et al 47 Wu et al 48 Akca et al 17 Ernst et al 15 Ueda et al †16 Horduna et al 49 Roy et al 50 Number of patients Wu et al 47 Wu et al 48 Akca et al 17 Ernst et al 15 Ueda et al †16 Horduna et al 49 Roy et al 50 7 ablation with RMT catheter (3 with 4 mm and 4 with 8 mm)…”

Section: General Experience With the Mns And Its Potential Advantagesmentioning

confidence: 99%

“…There are only case reports on successful AF ablation following ASD closure, 16,38 but studies on AF ablation using RMN in patients with structurally normal heart reported acceptable outcomes. 32,39 However, the retrograde approach is limited to the magnetic catheter without the ability to use a second diagnostic catheter (e.g., a circumferential mapping catheter) within the pulmonary veins.…”

Section: Asd Repair/ Percutaneous Asd Closure Devicementioning

confidence: 99%

Remote Magnetic Navigation for Catheter Ablation in Patients With Congenital Heart Disease: A Review

Roy

Gómez-Pulido

Ernst

2016

Cardiovasc electrophysiol

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Review on Remote Magnetic Navigation in Congenital Heart Disease. In patients with congenital heart disease, challenges to catheter-based arrhythmia interventions are unique and numerous given the complexity of the underlying defects, anatomic and surgical intervention variants including baffles, conduits, patches, and/or shunts. Remote magnetic navigation offers significant advantages in these cases that may present with limited vascular access or difficult access to the target cardiac chambers implicated by the previous surgical interventions. We reviewed the data available on the safety, feasibility, and effectiveness of magnetic navigation for the treatment of arrhythmia in congenital heart disease and discussed the specific challenges related to various congenital defects and repair with the potential advantages offered by magnetic navigation in these

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“…14 Potential advantages of these technologies include increased safety, more precise catheter manipulation and increased stability. 15 A number of studies have demonstrated that the results of PV isolation with remote navigation are comparable with conventional ablation techniques. 16,17 However, they are also associated with drawbacks, the most important of which relate to the cost and logistical aspects of installation of the technology.…”

Section: Remote Navigation Technologies For Af Ablationmentioning

confidence: 99%

New Ablation Technologies and Techniques

Mahida

Berte

Yamashita

et al. 2014

Arrhythmia &Amp; Electrophysiology Review

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Since the first catheter ablation for cardiac arrhythmia more than three decades ago, ablation technology has continually evolved at a rapid pace. Much of the early progress in the field was made in ablation of supraventricular tachycardias. Following a seminal study from Haïssaguerre et al. 1 in 1998, which demonstrated that pulmonary vein triggers are important sources of atrial fibrillation (AF), the approach to management of AF underwent a revolution. Electrical isolation of pulmonary veins (PVs) using catheter ablation became an established therapeutic strategy in patients with paroxysmal AF. During subsequent years, the role of ablation in AF expanded, and more extensive strategies involving ablation of non-pulmonary vein triggers and modification of the left atrial substrate were demonstrated to be effective, even in persistent forms of AF. New Technologies and Techniques for AF AblationCurrently, the most widely used technique for PV isolation involves delivery of point-by-point ablation lesions around the circumference of the vein. A number of different variations to the approach have been developed. During the early stages of PV isolation, a 'segmental approach' which involved targeting the earliest PV potentials at the ostium of the PV was commonly used. Due to high reconnection rates and the risk of PV stenosis, the technique has progressively been modified and the prevailing technique involves circumferential antral ablation to achieve PV isolation. AbstractCatheter ablation is an established treatment strategy for a range of different cardiac arrhythmias. Over the past decade two major areas of expansion have been ablation of atrial fibrillation (AF) and ventricular tachycardia (VT) in the context of structurally abnormal hearts. In parallel with the expanding role of catheter ablation for AF and VT, multiple novel technologies have been developed which aim to increase safety and procedural success. Areas of development include novel catheter designs, novel navigation technologies and higher resolution imaging techniques. The aim of the present review is to provide an overview of novel developments in AF ablation and VT ablation in patients with of structural cardiac diseases.

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Catheter Ablation Utilizing Remote Magnetic Navigation: A Review of Applications and Outcomes

Cited by 70 publications

References 41 publications

Efficacy and Safety of Atrial Fibrillation Ablation Using Remote Magnetic Navigation: Experience from 1,006 Procedures

Efficacy and Safety of Atrial Fibrillation Ablation Using Remote Magnetic Navigation: Experience from 1,006 Procedures

Remote Magnetic Navigation for Catheter Ablation in Patients With Congenital Heart Disease: A Review

New Ablation Technologies and Techniques

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