TY - JOUR
T1 - Mapping and ablation of ventricular arrhythmias with magnetic navigation
T2 - Comparison between 4- and 8-mm catheter tips
AU - Di Biase, Luigi
AU - Burkhardt, J. David
AU - Lakkireddy, Dhanunjaya
AU - Pillarisetti, Jayasree
AU - Baryun, Esam Nuri
AU - Biria, Mazda
AU - Horton, Rodney
AU - Sanchez, Javier
AU - Gallinghouse, G. Joseph
AU - Bailey, Shane
AU - Beheiry, Salwa
AU - Hongo, Richard
AU - Hao, Steven
AU - Tomassoni, Gery
AU - Natale, Andrea
PY - 2009/11
Y1 - 2009/11
N2 - Introduction: Remote magnetic navigation (RMN) has been reported as an effective and safe tool to overcome the need for advanced operator skill in the treatment of complex arrhythmias. We report a series of patients undergoing radiofrequency catheter ablation of ventricular arrhythmias (VAs) using RMN with either a 4-mm catheter tip or an 8-mm catheter tip at four different centers. Methods: Sixty-five patients with clinical and symptomatic history of Vas were included. Two different magnetic catheters were used to deliver radiofrequency applications remotely. When ablation with the RMN catheters failed, a manual irrigated catheter was used to eliminate the VAs. Post-ablation pacing maneuvers were utilized to verify the inducibility of Vas. Results: Twenty-eight patients (43%) had ischemic cardiomyopathy [coronary artery disease (CAD)], 16 patients (25%) had non-ischemic cardiomyopathy [idiopathic dilated cardiomyopathy (IDC)], and 21 patients (32%) had structurally normal hearts (SNH) or right ventricle outflow tract tachycardia (RVOT). In patients with structural heart disease (CAD, IDC), success was achieved in 22% with the 4-mm catheter tip and in 59% with the 8-mm catheter tip (p = 0.014). In patients with SNH/RVOT, success was achieved in 85% with the 4-mm catheter tip and in 87% with the 8-mm catheter tip (p = 1.00). Conclusions: Our findings showed that, with RMN, there is an increased success related to the catheter tip utilized. However, in patients with right ventricular outflow origin, the standard 4-mm tip provided adequate lesions for successful ablation in most patients.
AB - Introduction: Remote magnetic navigation (RMN) has been reported as an effective and safe tool to overcome the need for advanced operator skill in the treatment of complex arrhythmias. We report a series of patients undergoing radiofrequency catheter ablation of ventricular arrhythmias (VAs) using RMN with either a 4-mm catheter tip or an 8-mm catheter tip at four different centers. Methods: Sixty-five patients with clinical and symptomatic history of Vas were included. Two different magnetic catheters were used to deliver radiofrequency applications remotely. When ablation with the RMN catheters failed, a manual irrigated catheter was used to eliminate the VAs. Post-ablation pacing maneuvers were utilized to verify the inducibility of Vas. Results: Twenty-eight patients (43%) had ischemic cardiomyopathy [coronary artery disease (CAD)], 16 patients (25%) had non-ischemic cardiomyopathy [idiopathic dilated cardiomyopathy (IDC)], and 21 patients (32%) had structurally normal hearts (SNH) or right ventricle outflow tract tachycardia (RVOT). In patients with structural heart disease (CAD, IDC), success was achieved in 22% with the 4-mm catheter tip and in 59% with the 8-mm catheter tip (p = 0.014). In patients with SNH/RVOT, success was achieved in 85% with the 4-mm catheter tip and in 87% with the 8-mm catheter tip (p = 1.00). Conclusions: Our findings showed that, with RMN, there is an increased success related to the catheter tip utilized. However, in patients with right ventricular outflow origin, the standard 4-mm tip provided adequate lesions for successful ablation in most patients.
KW - 4-mm magnetic ablation catheter
KW - 8-mm magnetic ablation catheter
KW - Catheter ablation of ventricular tachycardia
KW - Open irrigation ablation catheter
KW - Remote magnetic catheter ablation
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U2 - 10.1007/s10840-009-9416-5
DO - 10.1007/s10840-009-9416-5
M3 - Article
C2 - 19639398
AN - SCOPUS:75549087032
SN - 1383-875X
VL - 26
SP - 133
EP - 137
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
IS - 2
ER -