Journal Article

Magnetic navigation in AV nodal re-entrant tachycardia study: early results of ablation with one- and three-magnet catheters

A.S. Thornton, P. Janse, D.A.M.J. Theuns, M.F. Scholten and L.J. Jordaens

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 8, issue 4, pages 225-230
Published in print April 2006 | ISSN: 1099-5129
Published online February 2006 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/euj026
Magnetic navigation in AV nodal re-entrant tachycardia study: early results of ablation with one- and three-magnet catheters

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Aims Steering soft, flexible catheters using an external magnetic field could have advantages for heart catheterization, especially for therapy of tachyarrhythmias. Our aims were to assess the feasibility of magnetic navigation to Koch's triangle and reliable ablation of atrioventricular nodal re-entry tachycardia (AVNRT) with a magnetic catheter.

Methods and results Consecutive patients with AVNRT were mapped and ablated with a magnetically enabled catheter (Helios I or II), with, respectively, one and three magnets at the tip. The catheter was remotely advanced with the Cardiodrive™ system and orientated with the Navigant™ control system. After initial positioning with the external magnets, adjustment was made in 5° steps. Success rates, procedure, and fluoroscopy times were analysed, and compared with a local contemporary series of conventional AVNRT ablations. Magnetic navigation was feasible in all 20 patients. Targets were easily reached. Catheters remained stable in position during accelerated junctional rhythms. Ablation was successful in 18/20 procedures (90%). No significant complications occurred. Median patient fluoroscopy time was 12 min, median physician fluoroscopy time was 4 min. Fluoroscopy times tended to be shorter than that in the conventionally treated group. Procedure duration decreased significantly over time, median procedure time was similar to that in the conventional group.

Conclusion AVNRT can be successfully mapped and ablated using magnetic navigation. A learning curve was evident, unrelated to catheter type, but to increasing operator experience. Physician radiation times were one-third of patient times. No complications occurred. Procedure time is comparable with that of conventional ablation.

Keywords: Arrhythmias; AV nodal re-entrant tachycardia; Catheter ablation; Magnetic navigation; Stereotactic therapy

Journal Article.  3039 words.  Illustrated.

Subjects: Cardiovascular Medicine

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