Robotic magnetic navigation-guided PVC ablation had an 11% acute failure rate, with a higher Navigation Index independently predicting lower failure risk (OR 0.1; 95% CI 0.05-0.20; p<0.001).
Cohort (n=824)
What are the rates and predictors of acute procedural failure in patients undergoing RMN-guided idiopathic PVC ablation?
RMN-guided idiopathic PVC ablation has an 11% acute failure rate, which is strongly predicted by the anatomical origin of the PVC and procedural efficiency.
Odds Ratio: 0.1 (95% CI 0.05–0.2)
p-value: p=<0.001
ABSTRACT Aims This retrospective analysis of our extensive experience focuses on idiopathic premature ventricular contractions (PVC) ablation guided by robotic magnetic navigation (RMN). Critical evaluation is given to the causes and impact of acute procedural failure. Methods This retrospective cohort study enrolled 824 patients (mean PVC burden 21.0 ± 6.6%) undergoing first‐time RMN‐guided PVC ablation. Acute failure was defined as recurrent clinical PVC during the observation period after the last radiofrequency (RF) application. The Navigation Index was calculated as the ratio of RF delivery time to total ablation time. Multivariate logistic regression was used to detect the impact factors of acute failure from patient demographics, PVC characteristics, and procedural parameters. Results The mean procedure and fluoroscopic times were 73.8 ± 38.3 and 2.6 ± 2.9 min, respectively. The overall acute procedural failure rate was 11% (90/824). Acute procedure failure was strongly dependent on the PVC origin: lowest in the right ventricular outflow tract (2.7%) and highest in the left ventricular summit (44%). The primary mechanisms were determined to be intramural origins (50%, 45/90) and proximity to high‐risk structures (24%, 22/90). Multivariate analysis identified PVC origin and Navigation Index (OR = 0.1, 95% CI 0.05–0.20; p < 0.001) as independent predictors of failure. A higher Navigation Index, reflecting greater procedural efficiency, correlated with procedural success. No major complications occurred, and minor complications were observed in 0.6% of patients. Conclusions RMN‐guided idiopathic PVC ablation demonstrated excellent safety and a relatively low acute procedural failure rate. Procedural outcomes are critically determined by the anatomical origin of the PVC and the procedural efficiency measured by the Navigation Index.
Luo et al. (Qui,) conduziram uma coorte em contrações ventriculares precoces idiopáticas (n=824). A ablação de PVC guiada por navegação magnética robótica (RMN) foi avaliada em relação à falha aguda do procedimento (OR 0.1, IC 95% 0.05-0.20, p=<0.001). A ablação guiada por navegação magnética robótica teve uma taxa de falha aguda de 11%, com um Índice de Navegação mais alto prevendo independentemente menor risco de falha (OR 0.1; IC 95% 0.05-0.20; p<0.001).