Journal article
Endo-epicardial ablation of ventricular arrhythmias in the left ventricle with the Remote Magnetic Navigation System and the 3.5-mm open irrigated magnetic catheter: Results from a large single-center case–control series
Heart rhythm, Vol.7(8), pp.1029-1035
08/01/2010
DOI: 10.1016/j.hrthm.2010.04.036
PMID: 20434589
Abstract
Remote magnetic navigation (RMN) has been reported as a feasible and safe mapping and ablation system for treatment of ventricular arrhythmias (VAs). However, the reported success rates have been limited with the 4- and 8-mm catheter tips.
This study sought to report the results in a large series of consecutive patients undergoing radiofrequency (RF) catheter ablation of VAs using the RMN with the 3.5-mm magnetic open-irrigated-tip catheter (OIC).
A total of 110 consecutive patients with a clinical history of left VA were included in the study. In all cases, an OIC was utilized for mapping and ablation. When ablation with the RMN catheters failed, a manual OIC was used to eliminate the VA. Postablation pacing maneuvers and isoproterenol were used to verify the inducibility of the VAs. Outcomes were compared with those of a group of 92 consecutive patients undergoing manual ablation by the same operator.
Mapping and ablation with the magnetic OIC were performed in all 110 patients with VA. Ischemic cardiomyopathy was present in 33 (30%), nonischemic in 14 (13%), and in 63 (57%) patients no structural heart disease was present. Endocardial mapping was performed in all patients, whereas both endocardial and epicardial mapping were performed in 36 (33%) patients. Compared with manual ablation, RMN was associated with a longer procedural time (2.9 ± 1.2 hours vs. 3.3 ± 1.1 hours,
P = 0.004) and RF time (24 ± 12 minutes vs. 33 ± 18 minutes,
P = 0.005), whereas fluoroscopic time was significantly shorter (35 ± 22 minutes vs. 26 ± 14 minutes,
P = 0.033). During the procedures, crossover to manual ablation was required in 15 patients (14%). At 11.7 ± 2.1 months of follow-up in the study group and 18.7 ± 3.7 months in the manual ablation group, 85% and 86% (
P = 0.817) of patients, respectively, were free of VA.
This large series of consecutive patients demonstrates that OIC ablation using RMN is effective for the treatment of left VAs.
Details
- Title: Subtitle
- Endo-epicardial ablation of ventricular arrhythmias in the left ventricle with the Remote Magnetic Navigation System and the 3.5-mm open irrigated magnetic catheter: Results from a large single-center case–control series
- Creators
- Luigi Di Biase - Texas Cardiac ArrhythmiaPasquale Santangeli - Texas Cardiac ArrhythmiaVladimir Astudillo - Texas Cardiac ArrhythmiaSergio Conti - Texas Cardiac ArrhythmiaPrasant Mohanty - Texas Cardiac ArrhythmiaSanghamitra Mohanty - Texas Cardiac ArrhythmiaJavier E. Sanchez - Texas Cardiac ArrhythmiaRodney Horton - Texas Cardiac ArrhythmiaBarbara Thomas - Texas Cardiac ArrhythmiaJ. David Burkhardt - Texas Cardiac ArrhythmiaAndrea Natale - Texas Cardiac Arrhythmia
- Resource Type
- Journal article
- Publication Details
- Heart rhythm, Vol.7(8), pp.1029-1035
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.hrthm.2010.04.036
- PMID
- 20434589
- ISSN
- 1547-5271
- eISSN
- 1556-3871
- Number of pages
- 7
- Language
- English
- Date published
- 08/01/2010
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984822988802771
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