Document Detail


Remote-controlled magnetic pulmonary vein isolation using a new irrigated-tip catheter in patients with atrial fibrillation.
MedLine Citation:
PMID:  20610835     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Lack of an irrigated-tip magnetic catheter has limited the role of remote-controlled magnetic navigation (Niobe II, Stereotaxis) for catheter ablation of atrial fibrillation (AF).
METHODS AND RESULTS: A novel 3.5-mm-tip irrigated magnetic catheter (group 1, Thermocool Navistar RMT, Biosense Webster) was used for 3D left atrial reconstruction (CARTO RMT) and remote-controlled magnetic pulmonary vein isolation. A redesigned catheter was used in group 2. The primary end point was wide area circumferential pulmonary vein isolation confirmed by spiral catheter recording during ablation; secondary end points included procedural data, complications, and AF recurrence. Fifty-six consecutive patients [group 1: 28 patients, 22 males, age 64 (38 to 78) years, left atrium: 47 (34 to 52) mm; paroxysmal AF: n=21, persistent AF: n=7; group 2: 28 patients, 20 males, age 60 (24 to 78) years, left atrium: 40 (35 to 53) mm; paroxysmal AF: n=18, persistent AF: n=10] were included. The primary end point was achieved in a total of 52 of 56 (93%) patients. Median procedure duration was 315 (125 to 550) minutes (group 1: 370 [230 to 550] minutes; group 2: 243 [125 to 450] minutes). Median fluoroscopy exposure to the investigator was reduced by 31%. Tip charring in 17 of 28 (61%) and complications in 3 of 28 (11%) patients in group 1 resulted in a catheter redesign. Sinus rhythm was maintained by 35 of 50 (70%) patients during a median follow-up period of 545 (100 to 683) days.
CONCLUSIONS: Remote-controlled magnetic AF ablation with real-time verification of pulmonary vein isolation is feasible with a comparable success rate to manual ablation. Safety improved after a redesign of the catheter.
Authors:
K R Julian Chun; Erik Wissner; Buelent Koektuerk; Melanie Konstantinidou; Boris Schmidt; Thomas Zerm; Andreas Metzner; Roland Tilz; Sigrid Boczor; Alexander Fuernkranz; Feifan Ouyang; Karl-Heinz Kuck
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-07-07
Journal Detail:
Title:  Circulation. Arrhythmia and electrophysiology     Volume:  3     ISSN:  1941-3084     ISO Abbreviation:  Circ Arrhythm Electrophysiol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-20     Completed Date:  2010-11-04     Revised Date:  2012-02-03    
Medline Journal Info:
Nlm Unique ID:  101474365     Medline TA:  Circ Arrhythm Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  458-64     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Asklepios Klinik St Georg, Hamburg, Germany. jongichun@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / physiopathology,  surgery*
Body Surface Potential Mapping
Catheter Ablation / instrumentation*
Catheterization, Central Venous / instrumentation*
Equipment Design
Feasibility Studies
Female
Heart Conduction System / physiopathology,  surgery*
Humans
Magnetics / methods*
Male
Middle Aged
Pulmonary Veins / innervation,  surgery*
Telemetry / methods*
Therapeutic Irrigation / instrumentation
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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