Efficacy and Safety of Atrial Fibrillation Ablation Using Remote Magnetic Navigation: Experience from 1,006 Procedures

BACKGROUND: The objective of this study was to assess the procedural outcomes of catheter ablation guided by remote magnetic navigation (RMN) in a large cohort of patients with paroxysmal trial fibrillation (PAF) and persistent AF (PerAF). METHODS: A total of 726 patients (547 male, age: 58.5 ± 10.3 years) with symptomatic AF (61% PAF) were analyzed from a prospective ablation registry. Procedural parameters including pulmonary venous (PV) anatomy, left atrial (LA) volume, procedural time, ablation time, fluoroscopy time, total X-ray dose, and complications were assessed. RESULTS: One thousand and six ablation procedures were analyzed. One-third of the patients (240/726) were ablated on more than one occasion, resulting in a mean of 1.3 ± 0.6 times for the entire group. When analyzing all procedures, the mean procedural time and ablation time was 134 ± 35 minutes and 2,130 ± 1,025 seconds, respectively. The mean fluoroscopy time was 5.4 ± 3.7 minutes. Compared to PAF patients, procedural time and ablation time were significantly increased in patients with PerAF by 10% (P < 0.001) and 19% (P < 0.001), respectively. However, fluoroscopy time was not increased (5.3 ± 3.5 minutes, PAF vs. 5.6 ± 4.0 minutes, PerAF, P = 0.17). The overall complication rate was 0.6%. One PAF patient experienced cardiac tamponade. AF repeat ablations by RMN significantly reduced the procedural and ablation times when compared with their first ablation times. CONCLUSIONS: AF ablation guided by RMN is safe as evidenced by a low complication rate. Fluoroscopy time was relatively short for both PAF and PerAF ablation.