Mapping and ablation of ventricular arrhythmias with magnetic navigation: Comparison between 4- and 8-mm catheter tips

Luigi Di Biase, J. David Burkhardt, Dhanunjaya Lakkireddy, Jayasree Pillarisetti, Esam Nuri Baryun, Mazda Biria, Rodney Horton, Javier Sanchez, G. Joseph Gallinghouse, Shane Bailey, Salwa Beheiry, Richard Hongo, Steven Hao, Gery Tomassoni, Andrea Natale

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)133-137
Number of pages5
JournalJournal of Interventional Cardiac Electrophysiology
Volume26
Issue number2
DOIs
StatePublished - Nov 2009
Externally publishedYes

Fingerprint

Cardiac Arrhythmias
Catheters
Heart Ventricles
Dilated Cardiomyopathy
Cardiomyopathies
Tachycardia
Coronary Artery Disease
Catheter Ablation
Patient Rights
Heart Diseases

Keywords

  • 4-mm magnetic ablation catheter
  • 8-mm magnetic ablation catheter
  • Catheter ablation of ventricular tachycardia
  • Open irrigation ablation catheter
  • Remote magnetic catheter ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)
  • Medicine(all)

Cite this

Mapping and ablation of ventricular arrhythmias with magnetic navigation : Comparison between 4- and 8-mm catheter tips. / Di Biase, Luigi; Burkhardt, J. David; Lakkireddy, Dhanunjaya; Pillarisetti, Jayasree; Baryun, Esam Nuri; Biria, Mazda; Horton, Rodney; Sanchez, Javier; Gallinghouse, G. Joseph; Bailey, Shane; Beheiry, Salwa; Hongo, Richard; Hao, Steven; Tomassoni, Gery; Natale, Andrea.

In: Journal of Interventional Cardiac Electrophysiology, Vol. 26, No. 2, 11.2009, p. 133-137.

Research output: Contribution to journalArticle

Di Biase, L, Burkhardt, JD, Lakkireddy, D, Pillarisetti, J, Baryun, EN, Biria, M, Horton, R, Sanchez, J, Gallinghouse, GJ, Bailey, S, Beheiry, S, Hongo, R, Hao, S, Tomassoni, G & Natale, A 2009, 'Mapping and ablation of ventricular arrhythmias with magnetic navigation: Comparison between 4- and 8-mm catheter tips', Journal of Interventional Cardiac Electrophysiology, vol. 26, no. 2, pp. 133-137. https://doi.org/10.1007/s10840-009-9416-5
Di Biase, Luigi ; Burkhardt, J. David ; Lakkireddy, Dhanunjaya ; Pillarisetti, Jayasree ; Baryun, Esam Nuri ; Biria, Mazda ; Horton, Rodney ; Sanchez, Javier ; Gallinghouse, G. Joseph ; Bailey, Shane ; Beheiry, Salwa ; Hongo, Richard ; Hao, Steven ; Tomassoni, Gery ; Natale, Andrea. / Mapping and ablation of ventricular arrhythmias with magnetic navigation : Comparison between 4- and 8-mm catheter tips. In: Journal of Interventional Cardiac Electrophysiology. 2009 ; Vol. 26, No. 2. pp. 133-137.
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abstract = "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.",
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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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