Xiaowei Qiu1, Ning Zhang2, Qingzhi Luo2, Ao Liu2, Yi Ji2, Jiawen Ye2, Changjian Lin2, Tianyou Ling2, Kang Chen2, Wenqi Pan2, Jianrong Zhao3, Qi Jin4, Liqun Wu5. 1. Department of Cardiology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Cardiology, Shanghai Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of Cardiology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 3. Department of Cardiology, Shanghai Ruijin Hospital Luwan Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 4. Department of Cardiology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: jinqi127@163.com. 5. Department of Cardiology, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. Electronic address: wuliqun89@hotmail.com.
Abstract
OBJECTIVE: The purpose of this study was to assess the role of remote magnetic navigation (RMN) in the ablation of ventricular premature complexes (VPCs) arising from outflow tracts (OT) and valve annuli by comparing to manual control navigation (MCN). METHODS: A total of 152 patients with frequent VPCs were prospectively enrolled. 64 (42%) patients underwent ablation guided by RMN. Acute success rate was defined as the complete elimination and non-inducibility of clinical VPCs during the procedure. RESULTS: Overall, acute success rate of RMN group was not different from MCN group (87.5% vs 84.1%, p = 0.56). Compared to MCN group, the fluoroscopic time of OT-VPCs ablation in the RMN group was significantly reduced by 67% (2.9 ± 2.3 min vs 8.9 ± 9.7 min, p = 0.006), and the ablation applications in successful cases were significantly reduced (11 ± 7 vs 15 ± 11, p = 0.018). Compared to MCN, RMN significantly decreased ablation applications (15 ± 9 vs 23 ± 9, p = 0.013) in the acute success rates of ablating VPCs of valve annulus, and has a trend of a higher success rate for VPCs arising from tricuspid annulus (10/11 vs 7/12, p = 0.193). No complications occurred in the RMN group. Three cases of cardiac tamponade and one case of transient atrioventricular block occurred in the MCN group (p = 0.22). After a mean follow up of 16.2 months, 2/56 and 3/74 patients had a recurrence of VPCs in the RMN group and MCN group respectively (p = 0.75). CONCLUSIONS: When compared to MCN, RMN-guided ablation for VPCs was just as effective and safe, with the added benefit of reduced fluoroscopic time and fewer ablation applications.
OBJECTIVE: The purpose of this study was to assess the role of remote magnetic navigation (RMN) in the ablation of ventricular premature complexes (VPCs) arising from outflow tracts (OT) and valve annuli by comparing to manual control navigation (MCN). METHODS: A total of 152 patients with frequent VPCs were prospectively enrolled. 64 (42%) patients underwent ablation guided by RMN. Acute success rate was defined as the complete elimination and non-inducibility of clinical VPCs during the procedure. RESULTS: Overall, acute success rate of RMN group was not different from MCN group (87.5% vs 84.1%, p = 0.56). Compared to MCN group, the fluoroscopic time of OT-VPCs ablation in the RMN group was significantly reduced by 67% (2.9 ± 2.3 min vs 8.9 ± 9.7 min, p = 0.006), and the ablation applications in successful cases were significantly reduced (11 ± 7 vs 15 ± 11, p = 0.018). Compared to MCN, RMN significantly decreased ablation applications (15 ± 9 vs 23 ± 9, p = 0.013) in the acute success rates of ablating VPCs of valve annulus, and has a trend of a higher success rate for VPCs arising from tricuspid annulus (10/11 vs 7/12, p = 0.193). No complications occurred in the RMN group. Three cases of cardiac tamponade and one case of transient atrioventricular block occurred in the MCN group (p = 0.22). After a mean follow up of 16.2 months, 2/56 and 3/74 patients had a recurrence of VPCs in the RMN group and MCN group respectively (p = 0.75). CONCLUSIONS: When compared to MCN, RMN-guided ablation for VPCs was just as effective and safe, with the added benefit of reduced fluoroscopic time and fewer ablation applications.