Literature DB >> 17218451

Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory.

Julian Kyoung-Ryul Chun1, Sabine Ernst, Shibu Matthews, Boris Schmidt, Dietmar Bansch, Sigrid Boczor, Amaar Ujeyl, Matthias Antz, Feifan Ouyang, Karl-Heinz Kuck.   

Abstract

AIMS: This study evaluates feasibility, safety, and efficacy of magnetic remote-controlled accessory pathway (AP) ablation. METHODS AND
RESULTS: The novel magnetic navigation system (MNS) (Niobe, Stereotaxis) creates a steerable magnetic field (0.08 T) controlling the distal magnetic tip of an ablation catheter. In conjunction with a catheter advancer system (Cardiodrive, Stereotaxis) remote catheter ablation is enabled. Conventional electrophysiology study identified AP conduction in 59 patients (37 males, 36+/-14 years, 60 APs). First generation 1-magnet tip (1-M) (group I, n=18), second generation bipolar 3-magnet tip (3-M) (group II, n=27), and third generation quadripolar 3-magnet tip catheters (3-M quad.) (group III, n=14) were used for magnetic remote-controlled ablation. Successful AP ablation was achieved in 67% (group I), 85% (group II), and 92% (group III). A significant decrease of median [IQR: Q1-Q3] fluoroscopy time and dosage was observed: 21.2 [12.1-33.8] min, 1110 [395-3234] microGym2 (group I); 6.5 [4.4-15.4] min, 290 [129-489] microGym2 (group II), and 4.9 [3.4-8.0] min, 129 [74-270] microGym2 (group III). Mean procedure time (217+/-67 min; 182+/-68 min, and 172+/-90 min) significantly decreased in group III. Median number [Q1-Q3] of radiofrequency current applications in groups I, II, and III was 4 [2-9], 4 [2-6], and 2 [2-4], respectively. No complications occurred.
CONCLUSION: Remote AP ablation is safe and feasible using the novel MNS. Introduction of the 3-magnet quadripolar ablation catheter significantly improved the efficacy of the procedure.

Entities:  

Mesh:

Year:  2007        PMID: 17218451     DOI: 10.1093/eurheartj/ehl447

Source DB:  PubMed          Journal:  Eur Heart J        ISSN: 0195-668X            Impact factor:   29.983


  20 in total

Review 1.  The art of war: Innate and adaptive immune responses.

Authors:  P W Dempsey; S A Vaidya; G Cheng
Journal:  Cell Mol Life Sci       Date:  2003-12       Impact factor: 9.261

2.  A Miniature Mobile Robot for Navigation and Positioning on the Beating Heart.

Authors:  Nicholas A Patronik; Takeyoshi Ota; Marco A Zenati; Cameron N Riviere
Journal:  IEEE Trans Robot       Date:  2009       Impact factor: 5.567

Review 3.  Magnetic and robotic navigation for catheter ablation: "joystick ablation".

Authors:  Sabine Ernst
Journal:  J Interv Card Electrophysiol       Date:  2008-06-07       Impact factor: 1.900

Review 4.  Catheter ablation - new developments in robotics.

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

Review 5.  Irrigated-Tip Magnetic Catheter Ablation Of AF: ALong-Term Prospective Study In 130 Patients.

Authors:  Julian Chun
Journal:  J Atr Fibrillation       Date:  2011-07-15

6.  Forces on cardiac implantable electronic devices during remote magnetic navigation.

Authors:  C Jilek; C Lennerz; B Stracke; H Badran; V Semmler; T Reents; S Ammar; S Fichtner; B Haller; G Hessling; I Deisenhofer; C Kolb
Journal:  Clin Res Cardiol       Date:  2012-09-29       Impact factor: 5.460

7.  Remote magnetic navigation system provides a superior catheter stability in acquisition of His bundle electrogram.

Authors:  Syed Muhammad Ali Tahir; G Muqtada Chaudhry; Muhammad Ali Syed; Thomas Marchese; Gregory Kotler; Charles I Haffajee; Michael V Orlov
Journal:  J Interv Card Electrophysiol       Date:  2008-03-21       Impact factor: 1.900

Review 8.  [Magnetic navigation in invasive electrophysiological diagnostic and therapy].

Authors:  R Schimpf; T Reents; G Hessling; I Deisenhofer; A Pflaumer; H Estner; J Wu; E Ucer; B Zrenner; T Sueselbeck; J Kuschyk; C Veltmann; M Borggrefe; C Wolpert
Journal:  Herzschrittmacherther Elektrophysiol       Date:  2007-09

9.  Motion-adapted catheter navigation with real-time instantiation and improved visualisation.

Authors:  Su-Lin Lee; Ka-Wai Kwok; Lichao Wang; Celia Riga; Colin Bicknell; Nicholas Cheshire; Guang-Zhong Yang
Journal:  J Robot Surg       Date:  2013-09-01

10.  Initial clinical experience of remote magnetic navigation system for catheter mapping and ablation of supraventricular tachycardias.

Authors:  Dongjie Xu; Bin Yang; Qijun Shan; Jiangang Zou; Minglong Chen; Chun Chen; Xiaofeng Hou; Fengxiang Zhang; Wen-Qi Li; Kejiang Cao; Hung-Fat Tse
Journal:  J Interv Card Electrophysiol       Date:  2009-03-05       Impact factor: 1.900

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