Magnetic guidance system for cardiac electrophysiology. a prospective trial of safety and efficacy in humans

Faddis, Mitchell N.; Chen, J.; Osborn, Jeff; Talcott, Michael; Cain, Michael E.; Lindsay, Bruce D.

doi:10.1016/j.accreview.2004.02.070

Cited by 62 publications

(99 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…To date, this platform system has been used in mapping and ablation of accessory pathways in patients with AV nodal or AV reentrant tachycardia and in the treatment of atrial fibrillation. [5][6][7] The present study examines the hypothesis that substrate-based endocardial and epicardial remote magnetic mapping and ablation can be safely and effectively performed in patients with scar-related VT.…”

Section: Clinical Perspective P 1200mentioning

confidence: 99%

“…The MNS uses 2 large magnets positioned on either side of the procedure table to generate a composite magnetic field for directional catheter orientation, as described previously. [5][6][7] The CARTO-RMT EAM platform is a prototype magnetic localization system similar to the standard CARTO system 8 ; the major important difference is its ability to localize the ablation catheter without interference from the MNS magnetic field. This EAM system can localize both standard CARTO and the specialized CARTO-RMT catheters.…”

Section: Remotely Guided Mnsmentioning

confidence: 99%

See 1 more Smart Citation

Remote Magnetic Navigation to Guide Endocardial and Epicardial Catheter Mapping of Scar-Related Ventricular Tachycardia

et al. 2007

View full text Add to dashboard Cite

Background-The present study examines the safety and feasibility of using a remote magnetic navigation system to perform endocardial and epicardial substrate-based mapping and radiofrequency ablation in patients with scar-related ventricular tachycardia (VT). Methods and Results-Using the magnetic navigation system, we performed 27 procedures on 24 consecutive patients with a history of VT related to myocardial infarction, dilated cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, hypertrophic cardiomyopathy, or sarcoidosis. Electroanatomic mapping of the left ventricular, right ventricular, and ventricular epicardial surfaces was constructed in 24, 10, and 12 patients, respectively. Completechamber VT activation maps were created in 4 patients. A total of 77 VTs were inducible, of which 21 were targeted during VT with the remotely navigated radiofrequency ablation catheter alone. With a combination of entrainment and activation mapping, 17 of 21 VTs (81%) were successfully terminated in a mean of 8.4Ϯ8.2 seconds; for the remainder, irrigated radiofrequency ablation was necessary. The mean fluoroscopy times for endocardial and epicardial mapping were 27Ϯ23 seconds (range, 0 to 105 seconds) and 18Ϯ18 seconds (range, 0 to 49 seconds), respectively. In concert with a manually navigated irrigated ablation catheter, 75 of 77 VTs (97%) were ultimately ablated. Four patients underwent a second procedure for recurrent VT, 3 with the magnetic navigation system. After 1.2 procedures per patient, VT did not recur during a mean follow-up of 7Ϯ3 months (range, 2 to 12 months). Conclusions-The present study demonstrates the safety and feasibility of remote catheter navigation to perform substrate mapping of scar-related VT in a wide range of disease states with a minimal amount of fluoroscopy exposure.

show abstract

Section: Clinical Perspective P 1200mentioning

confidence: 99%

Section: Remotely Guided Mnsmentioning

confidence: 99%

Remote Magnetic Navigation to Guide Endocardial and Epicardial Catheter Mapping of Scar-Related Ventricular Tachycardia

et al. 2007

View full text Add to dashboard Cite

show abstract

“…On the other hand, a number of reports have been published on using the magnetic navigation system to map and ablate the slow pathway or accessory pathways in patients with supraventricular tachycardias. 13,14 …”

Section: Prior Experience With Remote Navigationmentioning

confidence: 99%

View-Synchronized Robotic Image-Guided Therapy for Atrial Fibrillation Ablation

et al. 2007

View full text Add to dashboard Cite

Background-A robotic catheter navigation system has been developed that provides a significant degree of freedom of catheter movement. This study examines the feasibility of synchronizing this robotic navigation system with electroanatomic mapping and 3-dimensional computed tomography imaging to perform view-synchronized left atrial (LA) ablation. Methods and Results-This study consisted of a porcine experimental validation phase (9 animals) and a clinical feasibility phase (9 atrial fibrillation patients). Preprocedural computed tomography images were reconstructed to provide 3-dimensional surface models of the LA pulmonary veins and aorta. Aortic electroanatomic mapping was performed manually, followed by registration with the corresponding computed tomography aorta image using custom software. The mapping catheter was remotely manipulated with the robotic navigation system within the registered computed tomography image of the LA pulmonary veins. The point-to-surface error between the LA electroanatomic mapping data and the computed tomography image was 2.1Ϯ0.7 and 1.6Ϯ0.1 mm in the preclinical and clinical studies, respectively. The catheter was remotely navigated into all pulmonary veins, the LA appendage, and circumferentially along the mitral valve annulus. In 7 of 9 animals, circumferential radiofrequency ablation lesions were applied periostially to ablate 11 pulmonary veins. In patients, all of the pulmonary veins were remotely electrically isolated in an extraostial fashion. Adjunctive ablation included superior vena cava isolation in 6 patients, cavotricuspid isthmus ablation in 5 patients, and ablation of sites of complex fractionated activity and atypical LA flutters in 3 patients. Conclusions-This study demonstrates the safety and feasibility of an emerging paradigm for atrial fibrillation ablation involving the confluence of 3 technologies: 3-dimensional imaging, electroanatomic mapping, and remote robotic navigation.

show abstract

“…1,2 The remote magnetic navigation system (MNS) [3][4][5][6][7][8] has been introduced recently into clinical practice, which allows the use of a soft-tipped ablation catheter that can be guided to and positioned at the desired site by directional magnetic fields. On the other hand, the MNS is available and has been used with a nonirrigated magnetic tip catheter for RF ablation.…”

mentioning

confidence: 99%

Remote Magnetic Navigation With Irrigated Tip Catheter for Ablation of Paroxysmal Atrial Fibrillation

Miyazaki

Shah²,

Xhaët³

et al. 2010

Circ: Arrhythmia and Electrophysiology

View full text Add to dashboard Cite

Background— The remote magnetic navigation system (MNS) has been used with a nonirrigated magnetic catheter for atrial fibrillation (AF) ablation. The objective of this study was to evaluate the feasibility and efficiency of the newly available irrigated tip magnetic catheter for index pulmonary vein isolation (PVI) in patients with paroxysmal AF (PAF). Methods and Results— Between January 2008 and June 2009, 30 consecutive patients with drug-resistant PAF underwent circular mapping catheter-guided PVI with MNS (MNS group). The outcomes were compared retrospectively with those of a conventional hand-controlled ablation technique during the same period in 44 consecutive patients (manual group). All 4 pulmonary veins were successfully isolated in both groups except in 4 patients in the MNS group. Radiofrequency and procedure duration were higher in the MNS group (60±27 versus 43±16 minutes; P =0.0019) than in the manual group (246±50 versus 153±51 minutes; P <0.0001). In the patients who underwent only PVI, total fluoroscopic time also was longer in the MNS group than in the manual group (58±24 versus 40±14 minutes; P =0.0002). At 12-month follow-up after a single procedure, 69.0% of the patients in MNS group and 61.8% of patients in manual group were free of atrial tachyarrhythmia without antiarrhythmic drugs. There was no significant difference in the atrial tachyarrhythmia-free survival between the 2 groups ( P =0.961). Cardiac tamponade occurred in 1 patient in the manual group. Conclusions— In patients with PAF, MNS-guided PVI with the newly available irrigated tip magnetic catheter backed up with manual ablation whenever required is feasible. However, it requires longer ablation, fluoroscopy, and procedural times than the conventional approach in the early experience stage.

show abstract

Magnetic guidance system for cardiac electrophysiology. a prospective trial of safety and efficacy in humans

Cited by 62 publications

References 0 publications

Remote Magnetic Navigation to Guide Endocardial and Epicardial Catheter Mapping of Scar-Related Ventricular Tachycardia

Remote Magnetic Navigation to Guide Endocardial and Epicardial Catheter Mapping of Scar-Related Ventricular Tachycardia

View-Synchronized Robotic Image-Guided Therapy for Atrial Fibrillation Ablation

Remote Magnetic Navigation With Irrigated Tip Catheter for Ablation of Paroxysmal Atrial Fibrillation

Contact Info

Product

Resources

About