Andrew S Thornton1, Luc J Jordaens. 1. Department of Clinical Electrophysiology, Thoraxcentre, Erasmus Medical Centre, Rotterdam, The Netherlands. a.thornton@erasmusmc.nl
Abstract
BACKGROUND: Navigation, mapping, and ablation in the right ventricular outflow tract (RVOT) can be difficult. Catheter navigation using external magnetic fields may allow more accurate mapping and ablation. OBJECTIVES: The purpose of this study was to assess the feasibility of RVOT tachycardia ablation using remote magnetic navigation. METHODS: Mapping and ablation were performed in eight patients with outflow tract ventricular arrhythmias. Tachycardia mapping was undertaken with a 64-polar basket catheter, followed by remote activation and pace-mapping using a magnetically enabled catheter. The area of interest was localized on the basket catheter in seven patients in whom an RVOT arrhythmia was identified. Remote navigation of the magnetic catheter to this area was followed by pace-mapping. Ablation was performed at the site of perfect pace-mapping, with earliest activation if possible. RESULTS: Acute success was achieved in all patients (median four applications). Median procedural time was 144 minutes, with 13.4 minutes of patient fluoroscopy time and 3.8 minutes of physician fluoroscopy time. No complications occurred. One recurrence occurred during follow-up (mean 366 days). CONCLUSION: RVOT tachycardias can be mapped and ablated using remote magnetic navigation, initially guided by a basket catheter. Precise activation and pace-mapping are possible. Remote magnetic navigation permitted low fluoroscopy exposure for the physician. Long-term results are promising.
BACKGROUND: Navigation, mapping, and ablation in the right ventricular outflow tract (RVOT) can be difficult. Catheter navigation using external magnetic fields may allow more accurate mapping and ablation. OBJECTIVES: The purpose of this study was to assess the feasibility of RVOT tachycardia ablation using remote magnetic navigation. METHODS: Mapping and ablation were performed in eight patients with outflow tract ventricular arrhythmias. Tachycardia mapping was undertaken with a 64-polar basket catheter, followed by remote activation and pace-mapping using a magnetically enabled catheter. The area of interest was localized on the basket catheter in seven patients in whom an RVOT arrhythmia was identified. Remote navigation of the magnetic catheter to this area was followed by pace-mapping. Ablation was performed at the site of perfect pace-mapping, with earliest activation if possible. RESULTS: Acute success was achieved in all patients (median four applications). Median procedural time was 144 minutes, with 13.4 minutes of patient fluoroscopy time and 3.8 minutes of physician fluoroscopy time. No complications occurred. One recurrence occurred during follow-up (mean 366 days). CONCLUSION: RVOT tachycardias can be mapped and ablated using remote magnetic navigation, initially guided by a basket catheter. Precise activation and pace-mapping are possible. Remote magnetic navigation permitted low fluoroscopy exposure for the physician. Long-term results are promising.
Authors: K R Julian Chun; Boris Schmidt; Bülent Köktürk; Roland Tilz; Alexander Fürnkranz; Melanie Konstantinidou; Erik Wissner; Andreas Metzner; Feifan Ouyang; Karl-Heinz Kuck Journal: Herz Date: 2008-12 Impact factor: 1.443
Authors: B K R Schwagten; T Szili-Torok; M Rivero-Ayerza; E Jessurun; S Valk; L J L M Jordaens Journal: Neth Heart J Date: 2009-06 Impact factor: 2.380
Authors: Suzanne D A Valk; Natasja M S de Groot; Tamas Szili-Torok; Yves L E Van Belle; Jan C J Res; Luc Jordaens Journal: J Interv Card Electrophysiol Date: 2012-08-07 Impact factor: 1.900