Key result
Utilization of a steerable sheath during robotic magnetic navigation-guided atrial fibrillation ablation significantly reduced total procedure time (90.4 vs 111.9 minutes, p<0.001) compared to a fixed-curve sheath.
Why the study?
The impact of steerable sheaths compared with fixed-curve sheaths on the procedural outcomes of robotic magnetic navigation-guided AF ablation was not established.
Does a steerable sheath improve procedural efficiency in patients undergoing robotic magnetic navigation-guided atrial fibrillation ablation compared with a fixed-curve sheath?
Case-Control (n=110)
No
Does a steerable sheath improve procedural efficiency in patients undergoing robotic magnetic navigation-guided atrial fibrillation ablation compared with a fixed-curve sheath?
The use of a steerable sheath during robotic magnetic navigation-guided atrial fibrillation ablation significantly reduces procedure and radiofrequency times without compromising safety.
Steerable sheaths may improve RMN-guided AF ablation efficiency; leaves open need for randomized confirmation before practice change.
BACKGROUND: The objective of this study was to assess the impact of steerable sheaths compared with fixed-curve sheaths on the procedural outcomes of atrial fibrillation (AF) ablation guided by robotic magnetic navigation (RMN). METHODS AND RESULTS: In this retrospective case-control study, 110 patients scheduled for AF catheter ablation were enrolled and divided into two groups. Fifty-five patients (paroxysmal, 70%) were treated with RMN-guided ablation utilizing a steerable sheath and another 55 patients (paroxysmal, 70%) were ablated with RMN using a fixed-curve sheath. Clinical characteristics were similar between the two groups. Compared with the fixed-curve sheath group, the steerable sheath group procedure time (111.9 ± 25.2 vs. 90.4 ± 20.7 min, p < .001) and radiofrequency (RF) time (35.9 ± 9.0 vs. 30.5 ± 7.4 min, p < .001) were significantly shortened. Additionally, the navigation index was significantly improved (0.41 ± 0.06 vs. 0.48 ± 0.08, p < .001) in the steerable sheath group. By employing a large catheter loop for targeting the right pulmonary veins (PVs), the steerable sheath group significantly reduced the RF delivery time (15.0 ± 3.0 vs. 12.0 ± 2.1 min, p < .001) during right-side PV isolation (PVI). However, total fluoroscopy time was similar between the two groups (5.6 ± 2.6 vs. 5.0 ± 2.0 min, p > .05). Acute PVI success rates were similar between the two groups. No major or minor complications occurred in either group. CONCLUSION: Appropriate utilization of steerable sheath technology can improve the efficiency of AF ablation guided by RMN, primarily by reducing the total procedure and RF delivery times of right-side PVI without compromising safety.
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Luo et al. (2022) conducted a case-control in Atrial fibrillation (n=110). Steerable sheath vs. Fixed-curve sheath was evaluated on Procedure time (minutes) (p=<0.001). Utilization of a steerable sheath during robotic magnetic navigation-guided atrial fibrillation ablation significantly reduced total procedure time (90.4 vs 111.9 minutes, p<0.001) compared to a fixed-curve sheath.
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