TY - JOUR
T1 - Endo-epicardial ablation of ventricular arrhythmias in the left ventricle with the Remote Magnetic Navigation System and the 3.5-mm open irrigated magnetic catheter
T2 - Results from a large single-center case-control series
AU - Di Biase, Luigi
AU - Santangeli, Pasquale
AU - Astudillo, Vladimir
AU - Conti, Sergio
AU - Mohanty, Prasant
AU - Mohanty, Sanghamitra
AU - Sanchez, Javier E.
AU - Horton, Rodney
AU - Thomas, Barbara
AU - Burkhardt, J. David
AU - Natale, Andrea
PY - 2010
Y1 - 2010
N2 - Background: Remote magnetic navigation (RMN) has been reported as a feasible and safe mapping and ablation system for treatment of ventricular arrhythmias (VAs). However, the reported success rates have been limited with the 4- and 8-mm catheter tips. Objective: This study sought to report the results in a large series of consecutive patients undergoing radiofrequency (RF) catheter ablation of VAs using the RMN with the 3.5-mm magnetic open-irrigated-tip catheter (OIC). Methods: A total of 110 consecutive patients with a clinical history of left VA were included in the study. In all cases, an OIC was utilized for mapping and ablation. When ablation with the RMN catheters failed, a manual OIC was used to eliminate the VA. Postablation pacing maneuvers and isoproterenol were used to verify the inducibility of the VAs. Outcomes were compared with those of a group of 92 consecutive patients undergoing manual ablation by the same operator. Results: Mapping and ablation with the magnetic OIC were performed in all 110 patients with VA. Ischemic cardiomyopathy was present in 33 (30%), nonischemic in 14 (13%), and in 63 (57%) patients no structural heart disease was present. Endocardial mapping was performed in all patients, whereas both endocardial and epicardial mapping were performed in 36 (33%) patients. Compared with manual ablation, RMN was associated with a longer procedural time (2.9 ± 1.2 hours vs. 3.3 ± 1.1 hours, P = 0.004) and RF time (24 ± 12 minutes vs. 33 ± 18 minutes, P = 0.005), whereas fluoroscopic time was significantly shorter (35 ± 22 minutes vs. 26 ± 14 minutes, P = 0.033). During the procedures, crossover to manual ablation was required in 15 patients (14%). At 11.7 ± 2.1 months of follow-up in the study group and 18.7 ± 3.7 months in the manual ablation group, 85% and 86% (P = 0.817) of patients, respectively, were free of VA. Conclusion: This large series of consecutive patients demonstrates that OIC ablation using RMN is effective for the treatment of left VAs.
AB - Background: Remote magnetic navigation (RMN) has been reported as a feasible and safe mapping and ablation system for treatment of ventricular arrhythmias (VAs). However, the reported success rates have been limited with the 4- and 8-mm catheter tips. Objective: This study sought to report the results in a large series of consecutive patients undergoing radiofrequency (RF) catheter ablation of VAs using the RMN with the 3.5-mm magnetic open-irrigated-tip catheter (OIC). Methods: A total of 110 consecutive patients with a clinical history of left VA were included in the study. In all cases, an OIC was utilized for mapping and ablation. When ablation with the RMN catheters failed, a manual OIC was used to eliminate the VA. Postablation pacing maneuvers and isoproterenol were used to verify the inducibility of the VAs. Outcomes were compared with those of a group of 92 consecutive patients undergoing manual ablation by the same operator. Results: Mapping and ablation with the magnetic OIC were performed in all 110 patients with VA. Ischemic cardiomyopathy was present in 33 (30%), nonischemic in 14 (13%), and in 63 (57%) patients no structural heart disease was present. Endocardial mapping was performed in all patients, whereas both endocardial and epicardial mapping were performed in 36 (33%) patients. Compared with manual ablation, RMN was associated with a longer procedural time (2.9 ± 1.2 hours vs. 3.3 ± 1.1 hours, P = 0.004) and RF time (24 ± 12 minutes vs. 33 ± 18 minutes, P = 0.005), whereas fluoroscopic time was significantly shorter (35 ± 22 minutes vs. 26 ± 14 minutes, P = 0.033). During the procedures, crossover to manual ablation was required in 15 patients (14%). At 11.7 ± 2.1 months of follow-up in the study group and 18.7 ± 3.7 months in the manual ablation group, 85% and 86% (P = 0.817) of patients, respectively, were free of VA. Conclusion: This large series of consecutive patients demonstrates that OIC ablation using RMN is effective for the treatment of left VAs.
KW - Catheter ablation
KW - Left ventricle
KW - Magnetic robotic navigation
KW - Pericardial space
KW - Radiofrequency
KW - Ventricular arrhythmias
UR - http://www.scopus.com/inward/record.url?scp=77956861454&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77956861454&partnerID=8YFLogxK
U2 - 10.1016/j.hrthm.2010.04.036
DO - 10.1016/j.hrthm.2010.04.036
M3 - Article
C2 - 20434589
AN - SCOPUS:77956861454
SN - 1547-5271
VL - 7
SP - 1029
EP - 1035
JO - Heart Rhythm
JF - Heart Rhythm
IS - 8
ER -