Korean Circ J.  2011 May;41(5):248-252. 10.4070/kcj.2011.41.5.248.

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?

• Choi MS
• Oh YS
• Jang SW
• Kim JH
• Shin WS
• Youn HJ
• Jung WS
• Lee MY
• Seong KB

• KMID: 2297931
• DOI: http://doi.org/10.4070/kcj.2011.41.5.248

Abstract

BACKGROUND AND OBJECTIVES
Although there have been so many reports of catheter ablation of atrial fibrillation (AF) with magnetic navigation system (MNS), it is not necessarily obvious that MNS is more effective than conventional ablation. We performed AF ablation with MNS and compared the clinical outcomes and radiofrequency ablation parameters with those of conventional ablation.
SUBJECTS AND METHODS
One hundred eleven consecutive patients (conventional group, n=70 vs. MNS group, n=41) undergoing catheter ablation of AF were enrolled. We compared and analyzed the procedural parameters, namely fluoroscopic time, procedural time, acute procedural success and 3 months success rate of both groups.
RESULTS
The MNS group was associated with slightly larger left atrial size (43.7+/-6.3 mm vs. 41.2+/-6.3 mm, p=0.04), significantly longer total procedure time (352+/-50 minutes vs. 283+/-75 minutes, p<0.0001), and shorter total fluoroscopic time (99+/-28 minutes vs. 238+/-45 minutes, p<0.0001) than the conventional group. The MNS and conventional group did not differ with respect to acute procedural success, AF recurrence, atrial flutter/atrial tachycardia recurrence, or total arrhythmia recurrence. While no complications were observed in the MNS group, eight cases of significant pericardial effusion occurred in the conventional group.
CONCLUSION
The MNS system seems to be effective and safe in the catheter ablation of AF, particularly in the population of patients with persistent AF and slightly dilated left atria.

Keyword

Atrial fibrillation

MeSH Terms

Arrhythmias, Cardiac
Atrial Fibrillation
Catheter Ablation
Catheters
Humans
Magnetics
Magnets
Pericardial Effusion
Recurrence
Tachycardia

Reference

1. Ernst S, Ouyang F, Linder C, et al. Initial experience with remote catheter ablation using a novel magnetic navigation system: magnetic catheter ablation. Circulation. 2004. 109:1472–1475.

2. Chun JK, Ernst S, Matthews S, et al. Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory. Eur Heart J. 2007. 28:190–195.

3. Arya A, Kottkamp H, Piorkowski C, et al. Initial clinical experience with a remote magnetic catheter navigation system for ablation of cavotricuspid isthmus-dependent right atrial flutter. Pacing Clin Electrophysiol. 2008. 31:597–603.

4. Thornton AS, Jordaens LJ. Remote magnetic navigation for mapping and ablating right ventricular outflow tract tachycardia. Heart Rhythm. 2006. 3:691–696.

5. Pappone C, Vicedomini G, Manguso F, et al. Robotic magnetic navigation for atrial fibrillation ablation. J Am Coll Cardiol. 2006. 47:1390–1400.

6. Kim AM, Turakhia M, Lu J, et al. Impact of remote magnetic cathteter navigation on ablation fluoroscopy and procedure time. Pacing Clin Electrophysiol. 2008. 31:1399–1404.

7. Di Biase L, Fahmy TS, Patel D, et al. Remote magnetic navigation: human experience in pulmonary vein ablation. J Am Coll Cardiol. 2007. 50:868–874.

8. Dagres N, Hindricks G, Kottkamp H, et al. Complications of atrial fibrillation ablation in a high-volume center in 1,000 procedures: still cause for concern? J Cardiovasc Electrophysiol. 2009. 20:1014–1019.