Skip to main content

Advertisement

SpringerLink
Log in

Radiofrequency atrial fibrillation ablation with irrigated tip catheter using remote magnetic navigation compared with conventional manual method

  • Published:
Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Studies comparing manual catheter navigation (MCN) to remote magnetic navigation (RMN) for atrial fibrillation (AF) ablation showed variable results.

Objective

The aim of this meta-analysis is to compare the safety and clinical outcomes of AF radiofrequency (RF) ablation using MCN versus RMN with irrigated tip catheters.

Methods

Medline and the Cochrane Central Register of Controlled Trials (CENTRAL) were queried from inception through January 2019. Studies comparing safety and clinical outcomes of AF ablation with RF using MCN versus RMN with irrigated tip catheters were included. Random effects meta-analysis was used to pool outcomes across studies. Study endpoints included freedom of AF at the end of the study, procedure total time, fluoroscopy time, and complications.

Results

A total of 14 studies (3 controlled non-randomized trials, 1 prospective observational, and 10 retrospective observational studies) involving 3375 patients (1871 in MCN and 1504 in RMN) were included in this meta-analysis. There was no significant difference between the two groups in terms of freedom of AF (OR 1.08, 95% CI 0.82–1.42, p = 0.52). The MCN group was associated with shorter procedure time (mean difference in minutes − 50.39, 95% CI − 67.99 to − 32.79, p < 0.01), longer fluoroscopy time (mean difference in minutes 18.01, 95% CI 10.73–25.29, p < 0.01), and higher complication rate (OR 2.18, 95% CI 1.24–3.82, p < 0.01).

Conclusions

AF ablation utilizing MCN was associated with similar efficacy to RMN but with higher complication rates. Although the procedure time was shorter with MCN, the fluoroscopy time was more prolonged. Randomized clinical studies are needed to further verify these results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

Data availability

The data underlying this article were obtained by electronic search for studies pertaining to atrial fibrillation ablation catheters that are published in peer-review journals. All these studies are cited and listed in the reference list and provided with their unique identifier for online access.

References

  1. Zulkifly H, Lip GYH, Lane DA. Epidemiology of atrial fibrillation. Int J Clin Pract. 2018;72:e13070. https://doi.org/10.1111/ijcp.13070.

    Article  PubMed  Google Scholar 

  2. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary. J Am Coll Cardiol. 2014;64:2246–80. https://doi.org/10.1016/j.jacc.2014.03.021.

    Article  Google Scholar 

  3. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, et al. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation. Circulation. 2019;140. https://doi.org/10.1161/CIR.0000000000000665.

  4. Choi MS, Oh YS, Jang SW, Kim JH, Shin WS, Youn HJ, et al. Comparison of magnetic navigation system and conventional method in catheter ablation of atrial fibrillation: is magnetic navigation system is more effective and safer than conventional method? Korean Circ J. 2011;41:248–52. https://doi.org/10.4070/kcj.2011.41.5.248.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ernst S, Ouyang F, Linder C, Hertting K, Stahl F, Chun J, et al. Initial experience with remote catheter ablation using a novel magnetic navigation system. Circulation. 2004;109:1472–5. https://doi.org/10.1161/01.CIR.0000125126.83579.1B.

    Article  PubMed  Google Scholar 

  6. Aldhoon B, Wichterle D, Peichl P, Čihák R, Kautzner J. Complications of catheter ablation for atrial fibrillation in a high-volume centre with the use of intracardiac echocardiography. EP Eur. 2013;15:24–32. https://doi.org/10.1093/europace/eus304.

    Article  Google Scholar 

  7. Di Biase L, Fahmy TS, Patel D, Bai R, Civello K, Wazni OM, et al. Remote magnetic navigation. J Am Coll Cardiol. 2007;50:868–74. https://doi.org/10.1016/j.jacc.2007.05.023.

    Article  PubMed  Google Scholar 

  8. Dinov B, Schönbauer R, Wojdyla-Hordynska A, Braunschweig F, Richter S, ALTMANN D, et al. Long-term efficacy of single procedure remote magnetic catheter navigation for ablation of ischemic ventricular tachycardia: a retrospective study. J Cardiovasc Electrophysiol. 2012;23:499–505. https://doi.org/10.1111/j.1540-8167.2011.02243.x.

    Article  PubMed  Google Scholar 

  9. Higgins JPT. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557–60. https://doi.org/10.1136/bmj.327.7414.557.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Adragão PP, Gonçalves PA, Costa FM, Santos KR, Marques H, Carmo P, et al. Safety and long-term outcomes of catheter ablation of atrial fibrillation using magnetic navigation versus manual conventional ablation: a propensity-score analysis. J Cardiovasc Electrophysiol. 2016;27:S11–6. https://doi.org/10.1111/jce.12900.

    Article  PubMed  Google Scholar 

  11. Solheim E, Off MK, Hoff PI, De Bortoli A, Schuster P, Ohm OJ, et al. Remote magnetic versus manual catheters: evaluation of ablation effect in atrial fibrillation by myocardial marker levels. J Interv Card Electrophysiol. 2011;32:37–43. https://doi.org/10.1007/s10840-011-9567-z.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Sorgente A, Chierchia GB, Capulzini L, Yazaki Y, Muller-Burri A, Bayrak F, et al. Atrial fibrillation ablation: a single center comparison between remote magnetic navigation, cryoballoon and conventional manual pulmonary vein isolation. Indian Pacing Electrophysiol J. 2010;10:486–95.

    PubMed  PubMed Central  Google Scholar 

  13. Weiss P, May H, Bair T, Crandoll B, Cutler M, et al. A comparison of remote magnetic irrigated tip ablation versus manual catheter irrigated tip catheter ablation with and without force sensing feedback. J Cardiovasc Electrophysiol. 2016;27:S5–10. https://doi.org/10.1111/jce.12901.

    Article  PubMed  Google Scholar 

  14. Yuan S, Holmqvist F, Kongstad O, Jensen SM, Wang L, Ljungström E, et al. Long-term outcomes of the current remote magnetic catheter navigation technique for ablation of atrial fibrillation. Scand Cardiovasc J. 2017;51:308–15. https://doi.org/10.1080/14017431.2017.1384566.

    Article  PubMed  Google Scholar 

  15. Lüthje L, Vollmann D, Seegers J, Dorenkamp M, Sohns C, Hasenfuss G, et al. Remote magnetic versus manual catheter navigation for circumferential pulmonary vein ablation in patients with atrial fibrillation. Clin Res Cardiol. 2011;100:1003–11. https://doi.org/10.1007/s00392-011-0333-0.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Arya A, Zaker-Shahrak R, Sommer P, Bollmann A, Piorkowski C, Husser D, et al. Catheter ablation of atrial fibrillation using remote magnetic catheter navigation: a case-control study. Europace. 2010;13:45–50. https://doi.org/10.1093/europace/euq344.

    Article  PubMed  Google Scholar 

  17. Bun S-S, Ayari A, Latcu DG, Errahmouni A, Saoudi N. Radiofrequency catheter ablation of atrial fibrillation: electrical modification suggesting transmurality is faster achieved with remote magnetic catheter in comparison with contact force use. J Cardiovasc Electrophysiol. 2017;28:745–53. https://doi.org/10.1111/jce.13222.

    Article  PubMed  Google Scholar 

  18. Kataria V, Berte B, Tavernier R, Duytschaever M, Vandekerckhove Y. Remote magnetic versus manual navigation for radiofrequency ablation of paroxysmal atrial fibrillation: long-term, Controlled Data in a Large Cohort. Biomed Res Int. 2017;2017:1–6. https://doi.org/10.1155/2017/6323729.

    Article  Google Scholar 

  19. Kim AM, Turakhia M, Lu J, Badhwar N, Lee BK, Lee RJ, et al. Impact of remote magnetic catheter navigation on ablation fluoroscopy and procedure time. PACE - Pacing Clin Electrophysiol. 2008;31:1399–404. https://doi.org/10.1111/j.1540-8159.2008.01202.x.

    Article  PubMed  Google Scholar 

  20. Koutalas E, Bertagnolli L, Richter S, Rolf S, Sommer P, Rolf S, et al. Efficacy and safety of remote magnetic catheter navigation vs. manual steerable sheath-guided ablation for catheter ablation of atrial fibrillation: a case-control study. Europace. 2014;17:232–8. https://doi.org/10.1093/europace/euu224.

    Article  PubMed  Google Scholar 

  21. Lim PCY, Toh JJH, Loh JKXY, Lee ECY, Chong DTT, Tan BY, et al. Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: fluoroscopy reduction. J Arrhythmia. 2017;33:167–71. https://doi.org/10.1016/j.joa.2016.08.007.

    Article  Google Scholar 

  22. Miyazaki S, Shah AJ, Xhaët O, Derval N, Matsuo S, Wright M, et al. Remote magnetic navigation with irrigated tip catheter for ablation of paroxysmal atrial fibrillation. Circ Arrhythm Electrophysiol. 2010;3:585–9. https://doi.org/10.1161/CIRCEP.110.957803.

    Article  PubMed  Google Scholar 

  23. Haghjoo M, Hindricks G, Bode K, Piorkowski C, Bollmann A, Arya A. Initial clinical experience with the new irrigated tip magnetic catheter for ablation of scar-related sustained ventricular tachycardia: a small case series. J Cardiovasc Electrophysiol. 2009;20:935–9. https://doi.org/10.1111/j.1540-8167.2008.01416.x.

    Article  PubMed  Google Scholar 

  24. Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. Manual for cohort and case-control studies. Ottawa Hosp Res Inst. 2013.

  25. Suissa S. Calculation of number needed to treat. N Engl J Med. 2009;361(4):424–5. https://doi.org/10.1056/NEJMc0903274.

    Article  CAS  PubMed  Google Scholar 

  26. Cheng J, Pullenayegum E, Marshall JK, Iorio A, Thabane L. Impact of including or excluding both-armed zero-event studies on using standard meta-analysis methods for rare event outcome: a simulation study. BMJ Open. 2016;6:e010983. https://doi.org/10.1136/bmjopen-2015-010983.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kumar S, Chan M, Lee J, Wong MCG, Yudi M, Morton JB, et al. Catheter-tissue contact force determines atrial electrogram characteristics before and lesion efficacy after antral pulmonary vein isolation in humans. J Cardiovasc Electrophysiol. 2014;25:122–9. https://doi.org/10.1111/jce.12293.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Cardiology, Washington University, St Louis, MO, USA

    Rugheed Ghadban, Sandeep Sodhi & Daniel Cooper

  2. Department of General Medicine, University of Missouri Health Care, Columbia, MO, USA

    Kristina Gifft

  3. Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, MO, USA

    Zachary Luebbering

  4. Division of Cardiology, University of California Log Angeles-Harbor Medical Center, 1000 W Carson St., Torrance, CA, 90502, USA

    Tariq Enezate

Authors
  1. Rugheed Ghadban
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kristina Gifft
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Zachary Luebbering
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sandeep Sodhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daniel Cooper
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tariq Enezate
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tariq Enezate.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 837 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ghadban, R., Gifft, K., Luebbering, Z. et al. Radiofrequency atrial fibrillation ablation with irrigated tip catheter using remote magnetic navigation compared with conventional manual method. J Interv Card Electrophysiol 62, 95–102 (2021). https://doi.org/10.1007/s10840-020-00879-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10840-020-00879-8

Keywords

Search

Navigation