Remote magnetic navigation for pulmonary vein ablation achieved comparable acute procedural success (3.8 vs 3.7 pulmonary veins isolated, p=0.34) compared to manual navigation.
Observational (n=161)
No
Does remote magnetic navigation improve acute procedural success and long-term freedom from AF compared to manual navigation in patients undergoing pulmonary vein ablation for atrial fibrillation?
Remote magnetic navigation for pulmonary vein isolation is as safe and effective as manual navigation, significantly reducing fluoroscopy time but increasing overall procedure duration.
Absolute Event Rate: 3.8% vs 3.7%
p-value: p=0.34
BACKGROUND: Only limited data exist on the clinical utility of remote magnetic navigation (RMN) for pulmonary vein (PV) ablation. Aim of this prospective study was to evaluate the safety and efficacy of RMN for PV isolation as compared to the manual (CON) approach. METHODS AND RESULTS: A total of 161 consecutive patients undergoing circumferential PV isolation were included. Open-irrigated 3.5 mm ablation catheters under the guidance of a mapping system were used. The catheter was navigated with the Stereotaxis Niobe II system in the RMN group (n = 107) and guided manually in the CON group (n = 54). Electrical isolation of all PVs was achieved in 90% of the patients in the RMN group and in 87% in the CON group (p = 0.6). All subjects were followed every 3 months by 7d Holter-ECG. At 12 months of follow-up, 53.5% (RMN) and 55.5% (CON) of the patients were free of any left atrial tachycardia/atrial fibrillation (AF) episode (p = 0.57). Free of symptomatic AF recurrence were 66.3% (RMN) and 62.1% (CON) of the subjects (p = 0.80). Use of RMN was associated with longer procedure duration (p < 0.0001), ablation times (p < 0.0001), and RF current application duration (p < 0.05). In contrast, fluoroscopy time was lower in the RMN group (p < 0.0001). Major complications occurred in 6 of 161 procedures (3.7%), with no significant difference between groups (p = 0.75). CONCLUSION: RMN-guided PV ablation provides comparable acute and long-term success rates as compared to manual navigation. Procedural complication rates are similar. The use of RMN is associated with markedly reduced fluoroscopy time, but prolonged ablation and procedure duration.
Lüthje et al. (Sat,) conducted a observational in Atrial fibrillation (n=161). Remote magnetic navigation vs. Manual catheter navigation was evaluated on Acute procedural success (number of pulmonary veins isolated) (p=0.34). Remote magnetic navigation for pulmonary vein ablation achieved comparable acute procedural success (3.8 vs 3.7 pulmonary veins isolated, p=0.34) compared to manual navigation.