Remote accessory pathway ablation using a third-generation quadripolar 3-magnet catheter achieved a 92% success rate, compared to 67% with first-generation catheters.
Observational (n=59)
Does magnetic remote-controlled catheter ablation safely and effectively treat accessory pathways, and do newer catheter generations improve procedural outcomes?
Absolute Event Rate: 92% vs 67%
AIMS: This study evaluates feasibility, safety, and efficacy of magnetic remote-controlled accessory pathway (AP) ablation. METHODS AND RESULTS: The novel magnetic navigation system (MNS) (Niobe, Stereotaxis) creates a steerable magnetic field (0.08 T) controlling the distal magnetic tip of an ablation catheter. In conjunction with a catheter advancer system (Cardiodrive, Stereotaxis) remote catheter ablation is enabled. Conventional electrophysiology study identified AP conduction in 59 patients (37 males, 36+/-14 years, 60 APs). First generation 1-magnet tip (1-M) (group I, n=18), second generation bipolar 3-magnet tip (3-M) (group II, n=27), and third generation quadripolar 3-magnet tip catheters (3-M quad.) (group III, n=14) were used for magnetic remote-controlled ablation. Successful AP ablation was achieved in 67% (group I), 85% (group II), and 92% (group III). A significant decrease of median IQR: Q1-Q3 fluoroscopy time and dosage was observed: 21.2 12.1-33.8 min, 1110 395-3234 microGym2 (group I); 6.5 4.4-15.4 min, 290 129-489 microGym2 (group II), and 4.9 3.4-8.0 min, 129 74-270 microGym2 (group III). Mean procedure time (217+/-67 min; 182+/-68 min, and 172+/-90 min) significantly decreased in group III. Median number Q1-Q3 of radiofrequency current applications in groups I, II, and III was 4 2-9, 4 2-6, and 2 2-4, respectively. No complications occurred. CONCLUSION: Remote AP ablation is safe and feasible using the novel MNS. Introduction of the 3-magnet quadripolar ablation catheter significantly improved the efficacy of the procedure.
Chun et al. (Wed,) conducted a observational in Accessory pathway conduction (n=59). Magnetic remote-controlled accessory pathway ablation (third-generation 3-magnet quadripolar catheter) vs. First-generation 1-magnet tip catheter was evaluated on Successful accessory pathway ablation. Remote accessory pathway ablation using a third-generation quadripolar 3-magnet catheter achieved a 92% success rate, compared to 67% with first-generation catheters.