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Limpabandhu C, Hu Y, Ren H, Song W, Ho Tse ZT. Magnetically steerable catheters: State of the art review. Proc Inst Mech Eng H 2023; 237:297-308. [PMID: 36704957 PMCID: PMC10052423 DOI: 10.1177/09544119221148799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Magnetically steerable catheters (MSCs) have caught the interest of researchers due to their various potential uses in clinical applications, for example, minimally invasive surgery. Many significant advances in the design, implementation and analysis of MSCs have been accomplished in the last decade. This review concentrates on the configurations of current MSCs with an in depth look at control of the device and the specific workspace. This review also evaluates MSCs and references possible future system designs and difficulties. The concept of magnetic manipulation is briefly presented. Then, by category, the MSC is introduced. Following that, a discussion of future works and challenges of the review systems is provided. The conclusions are finally addressed.
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Affiliation(s)
- Chayabhan Limpabandhu
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
| | - Yihua Hu
- Department of Electronic Engineering, University of York, York, UK
| | - Hongliang Ren
- Department of Electronic Engineering, University of York, York, UK
| | - Wenzhan Song
- Department of Electronic Engineering, The Chinese University of Hong Kong, Hong Kong
| | - Zion Tsz Ho Tse
- School of Engineering and Materials Science, Queen Mary University of London, London, UK
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Atreya AR, Yalagudri SD, Subramanian M, Rangaswamy VV, Saggu DK, Narasimhan C. Best Practices for the Catheter Ablation of Ventricular Arrhythmias. Card Electrophysiol Clin 2022; 14:571-607. [PMID: 36396179 DOI: 10.1016/j.ccep.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Techniques for catheter ablation have evolved to effectively treat a range of ventricular arrhythmias. Pre-operative electrocardiographic and cardiac imaging data are very useful in understanding the arrhythmogenic substrate and can guide mapping and ablation. In this review, we focus on best practices for catheter ablation, with emphasis on tailoring ablation strategies, based on the presence or absence of structural heart disease, underlying clinical status, and hemodynamic stability of the ventricular arrhythmia. We discuss steps to make ablation safe and prevent complications, and techniques to improve the efficacy of ablation, including optimal use of electroanatomical mapping algorithms, energy delivery, intracardiac echocardiography, and selective use of mechanical circulatory support.
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Affiliation(s)
- Auras R Atreya
- Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and Research, Hyderabad, India; Division of Cardiovascular Medicine, Electrophysiology Section, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Sachin D Yalagudri
- Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and Research, Hyderabad, India
| | - Muthiah Subramanian
- Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and Research, Hyderabad, India
| | | | - Daljeet Kaur Saggu
- Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and Research, Hyderabad, India
| | - Calambur Narasimhan
- Electrophysiology Section, AIG Hospitals Institute of Cardiac Sciences and Research, Hyderabad, India.
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The First Evaluation of Remote Magnetic Navigation-Guided Pediatric Ventricular Arrhythmia Ablation. Pediatr Cardiol 2022; 43:1695-1703. [PMID: 35486130 PMCID: PMC9587922 DOI: 10.1007/s00246-022-02900-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
Abstract
Catheter ablation (CA) is an important treatment option for ventricular arrhythmias (VA) in pediatric cardiology. Currently, various CA techniques are available, including remote magnetic navigation (RMN)-guided radiofrequency (RF) ablation. However, no studies evaluate RMN-guided ablative therapy outcomes in children with VA yet. This study aimed to compare procedural and long-term outcomes between RMN-guided and manual (MAN)-guided VA ablation in children. This single-center, retrospective study included all CA procedures for VA performed in children with or without structural heart disease from 2008 until 2020. Two study groups were defined by CA technique: RMN or MAN. Primary outcome was recurrence of VA. Baseline clinical, procedural and safety data were also evaluated. This study included 22 patients, who underwent 30 procedures, with a median age of 15 (IQR 14-17; range 1-17) years and a mean weight of 57 ± 20 kg. In total, 14 procedures were performed using RMN and 16 using MAN (22 first and 8 redo procedures). Regarding first procedures, recurrence rates were significantly lower in RMN compared to MAN (20% versus 67%, P = 0.029), at a mean follow-up of 5.2 ± 3.0 years. Moreover, fluoroscopy dosages were significantly lower in RMN compared to MAN [20 (IQR 14-54) versus 48 (IQR 38-62) mGy, P = 0.043]. In total, 20 patients (91%) were free of VA following their final ablation procedure. This is the first study to investigate the use of RMN in pediatric VA ablation. RMN showed improved outcomes compared to MAN, resulting in lower VA recurrence and reduced fluoroscopy exposure.
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Benali K, Hammache N, Sellal JM, Mazen E, de Chillou C. Catheter knot around the mitral valve apparatus: An exceptional complication of remote magnetic navigation. J Cardiovasc Electrophysiol 2021; 33:137-139. [PMID: 34897865 DOI: 10.1111/jce.15313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/08/2021] [Accepted: 12/08/2021] [Indexed: 10/19/2022]
Abstract
Remote magnetic navigation (RMN) is as safe and effective as manual navigation for catheter ablation of ventricular arrhythmias. This case is the first description of a soft-tip ablation catheter entrapment in the mitral valve apparatus during an RMN ablation procedure. The tight knot created by the catheter around a mitral valve chordae required surgical removal. This complication, which has never been reported before, highlights the need for closer fluoroscopic monitoring when performing catheter loops inside the ventricles when using the RMN system.
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Affiliation(s)
- Karim Benali
- Department of Cardiology, Saint-Etienne University Hospital, Saint-Priest-En-Jarez, France.,INSERM-IADI, U947, Vandœuvre-lès-Nancy, France
| | - Nefissa Hammache
- INSERM-IADI, U947, Vandœuvre-lès-Nancy, France.,Department of Cardiology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Jean-Marc Sellal
- INSERM-IADI, U947, Vandœuvre-lès-Nancy, France.,Department of Cardiology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
| | - Elfarra Mazen
- Department of Cardiovascular Surgery and Heart Transplantations, Nancy University Hospital, France
| | - Christian de Chillou
- INSERM-IADI, U947, Vandœuvre-lès-Nancy, France.,Department of Cardiology, Nancy University Hospital, Vandœuvre-lès-Nancy, France
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Guckel D, Niemann S, Ditzhaus M, Molatta S, Bergau L, Fink T, Sciacca V, El Hamriti M, Imnadze G, Steinhauer P, Braun M, Khalaph M, Nölker G, Sommer P, Sohns C. Long-Term Efficacy and Impact on Mortality of Remote Magnetic Navigation Guided Catheter Ablation of Ventricular Arrhythmias. J Clin Med 2021; 10:jcm10204695. [PMID: 34682822 PMCID: PMC8540658 DOI: 10.3390/jcm10204695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/06/2021] [Accepted: 10/11/2021] [Indexed: 01/01/2023] Open
Abstract
Remote magnetic navigation (RMN) facilitates ventricular arrhythmia (VA) ablation. This study aimed to evaluate the long-term efficacy of RMN-guided ablation for ventricular tachycardia (VT) and premature ventricular contractions (PVC). A total of 176 consecutive patients (mean age 53.23 ± 17.55 years, 37% female) underwent VA ablation for PVC (132 patients, 75%) or VT (44 patients, 25%). The cohort consisted of 119 patients (68%) with idiopathic VA, 31 (18%) with ischemic (ICM), and 26 (15%) with dilated cardiomyopathy (DCM). VA recurrence was observed in 69 patients (39%, mean age 51.71 ± 19.91 years, 23% female) during a follow-up period of 5.48 years (first quartile 770.50 days, second quartile 1101.50 days, third quartile 1615.50 days). Left ventricular ejection fraction <40% lead to a significantly increased risk for VA (p = 0.031*). Multivariate analyses found DCM to be an independent predictor (IP) for VA recurrence (p < 0.001*, hazard ratio (HR) 3.74, confidence interval (CI) 1.58-8.88). ICM resulted in a lower increase in VA recurrence (p = 0.221, HR 1.49, CI 0.79-2.81). Class I/III/IV antiarrhythmic drug therapy (AADs) was also identified as IP for recurrence (p = 0.030*, HR 2.48, CI 1.11-5.68). A total of 16 patients (9%) died within the observational period. RMN-guided ablation of VA lead to acceptable long-term results. An impaired LV function, DCM, and AADs were associated with a significant risk for VA recurrence. Personalized paths are needed to improve efficacy and outcome.
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Affiliation(s)
- Denise Guckel
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Sarah Niemann
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Marc Ditzhaus
- Fakultät Statistik, Technische Universität Dortmund, 44227 Dortmund, Germany; (M.D.); (P.S.)
| | - Stephan Molatta
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Leonard Bergau
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Thomas Fink
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Vanessa Sciacca
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Mustapha El Hamriti
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Guram Imnadze
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Philipp Steinhauer
- Fakultät Statistik, Technische Universität Dortmund, 44227 Dortmund, Germany; (M.D.); (P.S.)
| | - Martin Braun
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Moneeb Khalaph
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Georg Nölker
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
- Clinic for Internal Medicine II/Cardiology, Christliches Klinikum Unna Mitte, 59423 Unna, Germany
| | - Philipp Sommer
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
| | - Christian Sohns
- Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universität Bochum, 32545 Bad Oeynhausen, Germany; (D.G.); (S.N.); (S.M.); (L.B.); (T.F.); (V.S.); (M.E.H.); (G.I.); (M.B.); (M.K.); (G.N.); (P.S.)
- Correspondence:
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Novel strategy of remote magnetic navigation-guided ablation for ventricular arrhythmias from right ventricle outflow tract. Sci Rep 2020; 10:17839. [PMID: 33082510 PMCID: PMC7575540 DOI: 10.1038/s41598-020-75032-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/09/2020] [Indexed: 11/15/2022] Open
Abstract
The optimized strategy to further increase the success rate of ablation for ventricular arrhythmias (VAs) from the right ventricular outflow tract (RVOT) is challenging. Recent studies have shown that the pulmonary sinus cusp (PSC) region may be the origin of certain RVOT VAs. We evaluated the efficacy of preferential ablation below the pulmonary valve (PV) and alternated radiofrequency delivery in the PSC using remote magnetic navigation (RMN). Sixty-five (65) consecutive patients experiencing VAs with RVOT-like appearance were included in this study. Mapping and ablation were preferentially performed below the PV. Ablation in the PSC would only be attempted when intensified ablation below the PV could not eliminate VAs. Finally, if ablation in the RVOT region failed, the aortic sinus cusp (ASC) would be mapped. Sixty-one (61) of 65 (93.8%) patients achieved procedural success. Except 7 cases of which the VAs were ablated in the ASC, the rest 54 VAs were thought to be originate from the RVOT region. Fifty (50) of 54 VAs were successfully ablated below the PV, and in the presence of a local special signal in the bipolar electrogram a more aggressive ablation was required. Subsequent ablation in the PSC with assistance of the RMN system achieved success in the remaining 4 patients. No complications occurred in this study. Our strategy of using RMN-guided ablation below the PV for VAs of RVOT origin was proved to be effective. PSC mapping and ablation using a magnetic catheter may provide the optimal strategy for treating these types of arrhythmias.
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Noten AME, Hendriks AA, Yap SC, Mol D, Bhagwandien R, Wijchers S, Kardys I, Khan M, Szili-Torok T. Contact feedback improves 1-year outcomes of remote magnetic navigation-guided ischemic ventricular tachycardia ablation. Int J Cardiol 2020; 315:36-44. [PMID: 32413467 DOI: 10.1016/j.ijcard.2020.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/30/2020] [Accepted: 05/11/2020] [Indexed: 10/24/2022]
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.
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Affiliation(s)
- Anna Maria Elisabeth Noten
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Astrid Armanda Hendriks
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Daniel Mol
- Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Rohit Bhagwandien
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Sip Wijchers
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Isabella Kardys
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Muchtiar Khan
- Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands
| | - Tamas Szili-Torok
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands.
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Noten AME, Géczy T, Yap SC, Kis Z, Szili-Torok T. Introducing a novel catheter-tissue contact feedback feature in robotic navigated catheter ablation: Utility, feasibility, and safety. Heart Rhythm O2 2020; 1:103-110. [PMID: 34113864 PMCID: PMC8183953 DOI: 10.1016/j.hroo.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background The quality of catheter–tissue contact is one of the most important determinants of catheter ablation (CA) success. The absence of catheter–tissue contact feedback has been regarded a major limitation of remote magnetic navigation (RMN)–guided CA. The e-Contact module (ECM) is a novel feature designed for RMN that measures the quality of catheter–tissue contact. Objective The purpose of this study was to describe the first clinical experience with this feature and to test its effect on procedural parameters and interference with other ablation equipment during CA procedures as well as its safety. Methods This was a prospective, single-center, 2-phase study investigating ECM use during complex RMN procedures in 30 patients. Impact of ECM on procedural parameters was evaluated in the feasibility phase (FP), and its interference with other equipment was tested in the interference phase (IP) using pacing maneuvers at 3 randomly selected right atrial sites. Intracardiac electrograms were evaluated for disturbances by 2 independent electrophysiologists. Results For FP, mean procedural time was 162 ± 66 minutes, fluoroscopy time 21 ± 9 minutes, and ablation time 34 ± 21 minutes. For IP, no significant differences in pacing capture or thresholds were found (ECM– vs ECM+: site 1: 2.05 vs 2.21 mA; P = .320; site 2: 2.15 vs 2.12 mA; P = .873; site 3: 2.51 vs 2.50 mA; P = .976). Electrogram disturbances did not significantly differ between ECM– and ECM+. No adverse events were reported. Conclusion The ECM is a novel catheter–tissue contact technology designed for RMN-guided CA. Our study suggests that this feature is feasible and does not interfere with other electrophysiology equipment while maintaining an excellent safety profile.
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Affiliation(s)
| | - Tamas Géczy
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Zsuzsanna Kis
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
| | - Tamas Szili-Torok
- Department of Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
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Xie Y, Jin Q, Zhang N, Liu A, Xing C, Jia K, Wei Y, Bao Y, Luo Q, Lin C, Ling T, Chen K, Pan W, Wu L. Strategy of catheter ablation for para‐Hisian premature ventricular contractions with the assistance of remote magnetic navigation. J Cardiovasc Electrophysiol 2019; 30:2929-2935. [DOI: 10.1111/jce.14245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/16/2019] [Accepted: 10/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Yun Xie
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Qi Jin
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Ning Zhang
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Ao Liu
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Chaofan Xing
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Kangni Jia
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Yue Wei
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Yangyang Bao
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Qingzhi Luo
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Changjian Lin
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Tianyou Ling
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Kang Chen
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Wenqi Pan
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
| | - Liqun Wu
- Department of Cardiology, Shanghai Ruijin HospitalShanghai Jiaotong University School of MedicineShanghai China
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Elisabeth Noten AM, Kis Z, Akca F, Bhagwandien R, Wijchers S, Yap SC, Szili-Torok T. Robotic navigation shows superior improvement in efficiency for atrial fibrillation ablation. J Atr Fibrillation 2019; 11:2108. [PMID: 31139295 DOI: 10.4022/jafib.2108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Revised: 07/18/2018] [Accepted: 11/30/2018] [Indexed: 12/27/2022]
Abstract
Background Because of the expanding atrial fibrillation (AF) burden, AF catheter ablation (CA) techniques have to become more efficient. Efficient AF CA procedures are characterized by successful pulmonary vein isolation (PVI) within reasonable procedure time. Currently there are many PVI techniques available and all show substantial improvements over time. However, the magnitude of improvement in procedural efficiency has not yet been compared between different techniques. The aim of this study was to compare efficiency improvement between manually (MAN) guided, cryoballoon (CB) and remote magnetic navigation (RMN) guided PVI. Methods A total of 221 patients were included in this retrospective study. Procedural parameters of 115 patients treated with first-generation PVI techniques (MAN-1, CB-1, RMN-1) performed in 2010, were compared to 106 patients who were treated with the latest, second generation techniques (MAN-2, CB-2, RMN-2). Efficiency was characterized by the following parameters: total ablation time, total procedure time, first pass isolation (FPI) (i.e. successful isolation after the first pulmonary vein (PV) encirclement) and touch-up rates. Results Every technique showed significant improvement of procedure times from the first to the second generation (P<0.001). In-between second generation techniques, the procedure times were comparable. The greatest magnitude of procedure time improvement was observed within the RMN groups (∆-180min), which was significantly greater compared to CB (∆-48 min, P<0.001) and MAN (∆-98min, P=0.011) groups. The highest FPI rates were observed in RMN-2 (78% and 74%; left and right PVs respectively), which was significantly higher compared to other techniques (MAN-2: 24% and 24%; CB-2: 50% and 48%; P<0.001). Conclusions The highest magnitude of efficiency improvement was detected in RMN guided PVI.
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Affiliation(s)
| | - Zsuzsanna Kis
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Ferdi Akca
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Rohit Bhagwandien
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Sip Wijchers
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Sing-Chien Yap
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Tamas Szili-Torok
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
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Noten AM, Van Mieghem NM, Szili-Torok T. Remote magnetic navigation-guided ventricular tachycardia ablation with continuous-flow mechanical circulatory support. HeartRhythm Case Rep 2019; 5:217-220. [PMID: 30997338 PMCID: PMC6453544 DOI: 10.1016/j.hrcr.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
| | | | - Tamas Szili-Torok
- Department of Cardiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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12
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Qian P, De Silva K, Kumar S, Nadri F, Samanta R, Bhaskaran A, Ross D, Sivagangabalan G, Cooper M, Kizana E, Davis L, Denniss AR, Thiagalingam A, Thomas S, Kovoor P. Early and long-term outcomes after manual and remote magnetic navigation-guided catheter ablation for ventricular tachycardia. Europace 2018; 20:ii11-ii21. [DOI: 10.1093/europace/euy057] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 03/12/2018] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pierre Qian
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Kasun De Silva
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
| | - Saurabh Kumar
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
| | - Fazlur Nadri
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Rahul Samanta
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Abhishek Bhaskaran
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - David Ross
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Gopal Sivagangabalan
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- School of Medicine, University of Notre Dame Australia, Sydney, Australia
| | - Mark Cooper
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
| | - Eddy Kizana
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Lloyd Davis
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Alan Robert Denniss
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Aravinda Thiagalingam
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Stuart Thomas
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Pramesh Kovoor
- Department of Cardiology, Westmead Hospital, Cnr of Hawkesbury and Darcy Rd, Westmead, Sydney, NSW 2145, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
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Turagam MK, Atkins D, Tung R, Mansour M, Ruskin J, Cheng J, Di Biase L, Natale A, Lakkireddy D. A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation. J Interv Card Electrophysiol 2017. [DOI: 10.1007/s10840-017-0257-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Burkhardt JD. Remote magnetic navigation for ventricular ablation: did the machine win this round? J Interv Card Electrophysiol 2016; 48:5-7. [PMID: 27722835 DOI: 10.1007/s10840-016-0197-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 10/02/2016] [Indexed: 01/06/2023]
Affiliation(s)
- J David Burkhardt
- Texas Cardiac Arrhythmia Institute, 3000 N. IH 35, Suite 700, Austin, TX, 78705, USA.
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15
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Da Costa A, Guichard JB, Roméyer-Bouchard C, Gerbay A, Isaaz K. Robotic magnetic navigation for ablation of human arrhythmias. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2016; 9:331-339. [PMID: 27698569 PMCID: PMC5034914 DOI: 10.2147/mder.s96167] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Radiofrequency treatment represents the first choice of treatment for arrhythmias, in particular complex arrhythmias and especially atrial fibrillation, due to the greater benefit/risk ratio compared to antiarrhythmic drugs. However, complex arrhythmias such as atrial fibrillation require long procedures with additional risks such as X-ray exposure or serious complications such as tamponade. Given this context, the treatment of arrhythmias using robotic magnetic navigation entails a technique well suited to complex arrhythmias on account of its efficacy, reliability, significant reduction in X-ray exposure for both patient and operator, as well as a very low risk of perforation. As ongoing developments will likely improve results and procedure times, this technology will become one of the most modern technologies for treating arrhythmias. Based on the literature, this review summarizes the advantages and limitations of robotic magnetic navigation for ablation of human arrhythmias.
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Affiliation(s)
- Antoine Da Costa
- North Hospital, Cardiology Department University of Saint Etienne Jean Monnet, Saint Etienne Cedex 2, France
| | - Jean Baptiste Guichard
- North Hospital, Cardiology Department University of Saint Etienne Jean Monnet, Saint Etienne Cedex 2, France
| | - Cécile Roméyer-Bouchard
- North Hospital, Cardiology Department University of Saint Etienne Jean Monnet, Saint Etienne Cedex 2, France
| | - Antoine Gerbay
- North Hospital, Cardiology Department University of Saint Etienne Jean Monnet, Saint Etienne Cedex 2, France
| | - Karl Isaaz
- North Hospital, Cardiology Department University of Saint Etienne Jean Monnet, Saint Etienne Cedex 2, France
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