Abstract
Purpose
The magnetic navigation system (MNS) has shown to be safe and effective for catheter ablation of atrial fibrillation (AF). However, longer procedure duration as compared to manual catheter ablation may limit its widespread use. This study aimed to assess the impact of the newest generation MNS using an optimized mapping and ablation protocol on the efficacy and safety of remote magnetic catheter (RMC)-guided pulmonary vein isolation (PVI).
Methods
This observational study included 52 patients with symptomatic AF who underwent RMC-guided PVI using the second-generation MNS Niobe II (initial 28 patients, group I) or the third-generation MNS Niobe ES in combination with an optimized mapping and ablation protocol (24 patients, group II).
Results
Acute PVI was achieved in 26/28 (93%) patients in group I and 24/24 patients (100%) in group II. Mean procedure time was 263.9 ± 81.9 min in group I and significantly lower in group II (139.7 ± 22.6 min, p < 0.01). Mean fluoroscopy time was 18.8 ± 8.7 min in group I and decreased to 7.9 ± 2.6 in group II (p < 0.01). After a median follow-up of 640.5 days (Q1 460.75; Q3 766.5), 16/24 (67%) patients undergoing RMC-guided PVI in group II remained in stable SR. No periprocedural complications were noted for either group.
Conclusions
Use of the third-generation MNS for RMC-guided PVI is safe, effective, and drastically reduced procedure times.
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All patients provided written informed consent. The study was approved by the local ethical board and was performed in accordance with the Declaration of Helsinki.
Conflicts of interest
Erik Wissner is a consultant to Stereotaxis. Karl-Heinz Kuck is a consultant to Stereotaxis and received research grants from Biosense Webster. All other authors report no conflict of interest.
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Maurer, T., Sohns, C., Deiss, S. et al. Significant reduction in procedure duration in remote magnetic-guided catheter ablation of atrial fibrillation using the third-generation magnetic navigation system. J Interv Card Electrophysiol 49, 219–226 (2017). https://doi.org/10.1007/s10840-017-0261-7
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DOI: https://doi.org/10.1007/s10840-017-0261-7