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Journal of Interventional Cardiac Electrophysiology

, Volume 49, Issue 3, pp 227–235 | Cite as

A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation

  • Mohit K. Turagam
  • Donita Atkins
  • Roderick Tung
  • Moussa Mansour
  • Jeremy Ruskin
  • Jie Cheng
  • Luigi Di Biase
  • Andrea Natale
  • Dhanunjaya Lakkireddy
Article

Abstract

Background

There are limited studies on the safety and efficacy of remote magnetic navigation (RMN) versus manual navigation (MAN) in ventricular tachycardia (VT) ablation.

Methods

A comprehensive literature search was performed using the keywords VT ablation, stereotaxis, RMN and MAN in Pubmed, Ebsco, Web of Science, Cochrane, and Google scholar databases.

Results

The analysis included seven studies (one randomized, three prospective observational, and three retrospective) including 779 patients [both structural heart disease (SHD) and idiopathic VT] comparing RMN (N = 433) and MAN (N = 339) in VT ablation. The primary end point of long-term VT recurrence was significantly lower with RMN (OR 0.61, 95% CI 0.44–0.85, p = 0.003) compared with MAN. Other end points of acute procedural success (OR 2.13, 95% CI 1.40–3.23, p = 0.0004) was significantly higher with RMN compared with MAN. Fluoroscopy [mean difference −10.42, 95% CI −12.7 to −8.1, p < 0.0001], procedural time [mean difference −9.79, 95% CI −19.27 to −0.3, p = 0.04] and complications (OR 0.35, 95% CI 0.17–0.74, p = 0.0006) were also significantly lower in RMN when compared with MAN. In a subgroup analysis SHD, there was no significant difference in VT recurrence or acute procedural success with RMN vs. MAN. In idiopathic VT, RMN significantly increased acute procedural success with no difference in VT recurrence.

Conclusion

The results demonstrate that RMN is safe and effective when compared with MAN in patients with both SHD and idiopathic VT undergoing catheter ablation. Further prospective studies are needed to further verify the safety and efficacy of RMN.

Keywords

Ventricular tachycardia Catheter ablation Stereotaxis Remote magnetic navigation and manual navigation system 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

None.

Ethical approval

None required.

Informed consent

Not required as this is from already published data.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Mohit K. Turagam
    • 1
  • Donita Atkins
    • 2
  • Roderick Tung
    • 3
  • Moussa Mansour
    • 4
  • Jeremy Ruskin
    • 4
  • Jie Cheng
    • 5
  • Luigi Di Biase
    • 6
  • Andrea Natale
    • 7
  • Dhanunjaya Lakkireddy
    • 2
  1. 1.Division of Cardiovascular MedicineUniversity of Missouri Hospital and ClinicsColumbiaUSA
  2. 2.Division of Cardiovascular Diseases, Cardiovascular Research InstituteUniversity of Kansas Hospital & Medical CenterKansas CityUSA
  3. 3.University of Chicago Medicine, Pritzker School of MedicineChicagoUSA
  4. 4.Massachusetts General HospitalBostonUSA
  5. 5.Texas Heart InstituteHoustonUSA
  6. 6.Albert Einstein College of MedicineNew YorkUSA
  7. 7.Texas Cardiac Arrhythmia Institute at St. David’s Medical CenterAustinUSA

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