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January 8, 2024Heart and VesselsOpen Access

Manual contact-force ablation links to ~65% greater freedom from AF recurrence versus remote magnetic navigation.

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Why the study?

Data comparing remote magnetic catheter navigation with manual catheter navigation combined with contact force sensing for atrial fibrillation ablation were lacking.

Does manual catheter navigation with contact force sensing reduce AF recurrence in patients undergoing ablation of atrial fibrillation compared to remote magnetic navigation?

Population

452 patients undergoing 605 ablations of AF

Comparison

RMN ablation vs MCN-CF ablation

Design

Retrospective single-center comparative study

Follow-up

Mean 1.6 ± 1.6 years

Key result

Manual catheter navigation with contact force sensing significantly increased freedom from atrial fibrillation recurrence to 81% compared to 53% with remote magnetic navigation.

Authors

SSSimon SchlöglKSKlaudia Stella SchlöglPBPhilipp Bengel

Discussion

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Overview

MCN-CF linked to lower AF recurrence than RMN; should not change practice pending randomized confirmation.

Study Design

Type

Cohort (n=452)

Multicenter

No

Structured PICO

Does manual catheter navigation with contact force sensing reduce AF recurrence in patients undergoing ablation of atrial fibrillation compared to remote magnetic navigation?

P
Population
452 patients with symptomatic drug-refractory atrial fibrillation undergoing percutaneous pulmonary vein isolation, followed for a mean of 1.6 years.
E
Exposure
Manual catheter navigation in combination with contact force sensing (MCN-CF) ablation
C
Comparator
Remote magnetic catheter navigation (RMN) ablation
O
Outcome
AF recurrence

Main Result

Hazard Ratio: 1.651 (95% CI 1.294–2.106)

Absolute Event Rate: 81% vs 53%

p-value: p=<0.001

Manual catheter navigation with contact force sensing is associated with significantly lower AF recurrence and pulmonary vein reconnection rates compared to remote magnetic navigation.

Limitations

  • Registry-based, single-center retrospective study design
  • Asymptomatic episodes of atrial fibrillation may have been missed
  • Patients in the two groups were treated in different time spans (RMN 2008-2014, MCN-CF 2014-2018)
  • Potential bias from increasing operator experience over time
  • Did not incorporate ablation index or Carto Visitag module
  • Remote magnetic navigation catheters lacked contact force sensing

Cite This Study

Schlögl et al. (2024) conducted a cohort in Atrial fibrillation (n=452). Manual catheter navigation with contact force sensing (MCN-CF) vs. Remote magnetic catheter navigation (RMN) was evaluated on Freedom from atrial fibrillation recurrence (HR 1.651, 95% CI 1.294-2.106, p=<0.001). Manual catheter navigation with contact force sensing significantly increased freedom from atrial fibrillation recurrence to 81% compared to 53% with remote magnetic navigation.

synapsesocial.com/papers/6a4c43d01ca1d7ad2a60e894https://doi.org/10.1007/s00380-023-02344-8
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Remote magnetic navigation versus manual catheter ablation of atrial fibrillation: A single center long‐term comparison2021 · 14 citations
  2. 2Efficacy and safety of remote magnetic catheter navigation vs. manual steerable sheath-guided ablation for catheter ablation of atrial fibrillation: a case-control study2014 · 24 citations
  3. 3Comparison of atrial fibrillation ablation efficacy using remote magnetic navigation vs. manual navigation with contact-force control2019 · 8 citations
  4. 4Remote magnetic with open-irrigated catheter vs. manual navigation for ablation of atrial fibrillation: a systematic review and meta-analysis2013 · 63 citations
  5. 5A Comparison of Remote Magnetic Irrigated Tip Ablation versus Manual Catheter Irrigated Tip Catheter Ablation With and Without Force Sensing Feedback2016 · 36 citations