The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias

Abstract

AimsWe aimed to evaluate the safety and long-term efficacy of the magnetic navigation system (MNS) in a large number of patients. The MNS has the potential for improving safety and efficacy based on atraumatic catheter design and superior navigation capabilities.Methods and resultsIn this study, 610 consecutive patients underwent ablation. Patients were divided into two age- and sex-matched groups. Ablations were performed either using MNS (group MNS, 292) or conventional manual ablation [group manual navigation (MAN), 318]. The following parameters were analysed: acute success rate, fluoroscopy time, procedure time, complications [major: pericardial tamponade, permanent atrioventricular (AV) block, major bleeding, and death; minor: minor bleeding and temporary AV block]. Recurrence rate was assessed during follow-up (15 ± 9.5 months). Subgroup analysis was performed for the following groups: atrial fibrillation, isthmus dependent and atypical atrial flutter, atrial tachycardia, AV nodal re-entrant tachycardia, circus movement tachycardia, and ventricular tachycardia (VT). Magnetic navigation system was associated with less major complications (0.34 vs. 3.2%, P = 0.01). The total numbers of complications were lower in group MNS (4.5 vs. 10%, P = 0.005). Magnetic navigation system was equally effective as MAN in acute success rate for overall groups (92 vs. 94%, P = ns). Magnetic navigation system was more successful for VTs (93 vs. 72%, P < 0.05). Less fluoroscopy was used in group MNS (30 ± 20 vs. 35 ± 25 min, P < 0.01). There were no differences in procedure times and recurrence rates for the overall groups (168 ± 67 vs. 159 ± 75 min, P = ns; 14 vs. 11%, P = ns; respectively).ConclusionsOur data suggest that the use of MNS improves safety without compromising efficiency of ablations. Magnetic navigation system is more effective than manual ablation for VTs.

Magnetic Versus Manual Catheter Navigation for Ablation of Free Wall Accessory Pathways in Children

“…This is similar to early findings in larger adult studies evaluating the use of MN in other forms of arrhythmias. 6,12 In our study, the reason for reduced fluoroscopy times with MN is not entirely clear because both navigation methodologies did incorporate 3-dimensional mapping. In our institution, however, this may have been partially related to active fellowship training.…”

“…10 Early studies in adults using remote MN for ablation of various types of arrhythmias have been promising with improved safety and equivalent efficacy profiles compared with standard manual techniques. 6,11,12 In children, data remain limited. An initial report by Schwagten et al 8 in a series of children and adults with complex congenital heart disease found that RF ablation using MN for arrhythmias in this cohort was safe and effective.…”

“…Early studies in adults have found MN to be safe and effective for ablation of various arrhythmias, including atrial fibrillation, atrial flutter, atrioventricular nodal reentry, and ventricular tachycardia with an apparent decreased need for fluoroscopy. 6,7 Preliminary evaluation in children and adults with congenital heart disease also found MN to have potential advantages in this specialized cohort without compromising efficacy. 8,9 Little data exist regarding the use of MN and its potential benefits for ablation of standard AP-mediated tachycardia in children.…”

Role of catheter ablation of ventricular tachycardia associated with structural heart disease

“…Single center studies show that in VT patients, endocardial and epicardial mapping and ablation using this system is safe and feasible with minimal radiation exposure for the patient [70,71] . It has been recently reported that remote magnetic navigation may be more effective than manual ablation [72] . On the other hand, the disadvantages of this system are mainly represented by costs and the need for appropriate location and magnetic shielding.…”

Catheter Ablation of Complex Tachyarrhythmias Using Remote Magnetic Catheter Navigation System

“…The system has two large computer-controlled magnets, located on each side of the patient, that generate a magnetic field vector (0.08 or 0.10 Tesla) in any direction at the center of the patient's chest to control catheter movement. [6][7][8] The RMN system utilizes a soft, flexible mapping/ablation catheter with three magnets to respond to the external magnetic field, and then can be advanced or retracted remotely using a catheter-advancer system (Cardiodrive, Stereotaxis, Inc). A 3-D electroanatomical mapping system (CARTO-RMT, Biosense Webster, Inc., Diamond Bar, CA, USA) has been integrated for use with the RMN system.…”