Anna Maria Elisabeth Noten1, Astrid Armanda Hendriks1, Sing-Chien Yap2, Daniel Mol3, Rohit Bhagwandien2, Sip Wijchers2, Isabella Kardys2, Muchtiar Khan3, Tamas Szili-Torok4. 1. Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. 2. Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. 3. Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands. 4. Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands. Electronic address: t.szilitorok@erasmusmc.nl.
Abstract
INTRODUCTION: Remote magnetic navigation (RMN)-guided catheter ablation (CA) is a feasible treatment option for patients presenting with ischemic ventricular tachycardia (VT). Catheter-tissue contact feedback, enhances lesion formation and may consequently improve CA outcomes. Until recently, contact feedback was unavailable for RMN-guided CA. The novel e-Contact Module (ECM) was developed to continuously monitor and ensure catheter-tissue contact during RMN-guided CA. OBJECTIVE: The present study aims to evaluate the effect of ECM implementation on acute and long-term outcomes in RMN-guided ischemic VT ablation. METHOD: This retrospective, two-center study included consecutive ischemic VT patients undergoing RMN-guided CA from 2010 to 2017. Baseline clinical data, procedural data, including radiation times, and acute success rates were compared between CA procedures performed with ECM (ECM+) and without ECM (ECM-). One-year VT-free survival was analyzed using Cox-proportional hazards models, adjusting for potential confounders: age, left ventricular function, VT inducibility at baseline and substrate based ablation strategy. RESULTS: The current study included 145 patients (ECM+ N = 25, ECM- N = 120). Significantly lower fluoroscopy times were observed in the ECM+ group (9.5 (IQR 5.3-13.5) versus 12.5 min (IQR 8.0-18.0), P = 0.025). Non-inducibility of the clinical VT at the end of procedure was observed in 92% ECM+ versus 72% ECM- patients (P = 0.19). ECM guidance was associated with significantly lower VT-recurrence rates during 1-year follow-up (16% ECM+ versus 40% ECM-; multivariable HR 0.29, 95%-CI 0.10-0.69, P = 0.021, reference group: ECM-). CONCLUSION: Contact feedback by the ECM further decreases fluoroscopy exposure and improves VT-free survival in RMN-guided ischemic VT ablation.
INTRODUCTION: Remote magnetic navigation (RMN)-guided catheter ablation (CA) is a feasible treatment option for patients presenting with ischemic ventricular tachycardia (VT). Catheter-tissue contact feedback, enhances lesion formation and may consequently improve CA outcomes. Until recently, contact feedback was unavailable for RMN-guided CA. The novel e-Contact Module (ECM) was developed to continuously monitor and ensure catheter-tissue contact during RMN-guided CA. OBJECTIVE: The present study aims to evaluate the effect of ECM implementation on acute and long-term outcomes in RMN-guided ischemic VT ablation. METHOD: This retrospective, two-center study included consecutive ischemic VTpatients undergoing RMN-guided CA from 2010 to 2017. Baseline clinical data, procedural data, including radiation times, and acute success rates were compared between CA procedures performed with ECM (ECM+) and without ECM (ECM-). One-year VT-free survival was analyzed using Cox-proportional hazards models, adjusting for potential confounders: age, left ventricular function, VT inducibility at baseline and substrate based ablation strategy. RESULTS: The current study included 145 patients (ECM+ N = 25, ECM- N = 120). Significantly lower fluoroscopy times were observed in the ECM+ group (9.5 (IQR 5.3-13.5) versus 12.5 min (IQR 8.0-18.0), P = 0.025). Non-inducibility of the clinical VT at the end of procedure was observed in 92% ECM+ versus 72% ECM- patients (P = 0.19). ECM guidance was associated with significantly lower VT-recurrence rates during 1-year follow-up (16% ECM+ versus 40% ECM-; multivariable HR 0.29, 95%-CI 0.10-0.69, P = 0.021, reference group: ECM-). CONCLUSION: Contact feedback by the ECM further decreases fluoroscopy exposure and improves VT-free survival in RMN-guided ischemic VT ablation.
Authors: Anna M E Noten; Nawin L Ramdat Misier; Janneke A E Kammeraad; Sip Wijchers; Ingrid M Van Beynum; Michiel Dalinghaus; Thomas B Krasemann; Sing-Chien Yap; Natasja M S de Groot; Tamas Szili-Torok Journal: Pediatr Cardiol Date: 2022-04-29 Impact factor: 1.838
Authors: Pál Ábrahám; Mercédesz Ambrus; Szilvia Herczeg; Nándor Szegedi; Klaudia Vivien Nagy; Zoltán Salló; István Osztheimer; Gábor Széplaki; Tamás Tahin; Béla Merkely; László Gellér Journal: Europace Date: 2021-04-06 Impact factor: 5.214
Authors: Anna M E Noten; Janneke A E Kammeraad; Nawin L Ramdat Misier; Sip Wijchers; Ingrid M van Beynum; Michiel Dalinghaus; Thomas B Krasemann; Sing-Chien Yap; Natasja M S de Groot; Tamas Szili-Torok Journal: Int J Cardiol Heart Vasc Date: 2021-10-01
Authors: Rita B Gagyi; Anna M E Noten; Sip Wijchers; Sing-Chien Yap; Rohit E Bhagwandien; Mark G Hoogendijk; Tamas Szili-Torok Journal: Int J Cardiol Heart Vasc Date: 2022-07-21