Catheter ablation of incisional atrial tachycardia using remote magnetic navigation in patients after heart surgery: comparison between acquired and congenital heart disease

Aims: The objectives of this study were to assess the acute and long-term outcomes of catheter ablation in incisional atrial tachycardia (IAT) using remote magnetic navigation (RMN) in patients after heart surgery. Methods and results: A total of 46 patients with IAT after heart surgery who underwent catheter ablation using RMN were included. Of these patients, 22 patients had acquired heart disease (AHD) and the remaining 24 patients had various types of congenital heart disease (CHD). In these 46 patients, 57 re-entry circuits were found in 56 procedures. The re-entry circuits were mainly distributed in right atrium (RA). Acute success of first ablation reached in 42 of 46 (91%) patients. Mean procedure duration was 115 ± 39 min, ablation duration was 678 (920.5) s, X-ray time was 4 (4.8) min, and X-ray dose was 3 (6.0) gy cm2. After a mean follow-up of 28 ± 19 months, 39 of 46 (85%) patients were free from IAT. No major complications were observed. There were no significant differences in procedure durations (AHD 113 ± 40 min vs. CHD 119 ± 38 min), ablation durations [AHD 643 (1027) s vs. CHD 712 (929) s], X-ray time [AHD 4 (4.5) min vs. CHD 4 (5.0) min], circuits in RA (AHD 85% vs. CHD 86%), acute success rates (AHD 91% vs. CHD 92%), and long-term success rates (AHD 86% vs. CHD 83%) between the two groups (P > 0.05). Conclusion: Catheter ablation of IAT in patients after heart surgery using RMN is safe and effective. No significant differences related to success rates and procedure characteristics were found between patients with AHD and CHD.