Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction
Background: Percutaneous transcatheter radiofrequency ablation of atrial fibrillation with remote controlled magnetic navigation (RMN) has been shown to reduce radiation exposure to patients and physicians compared with conventional manual (MAN) ablation techniques. Methods: Catheter ablation for at...
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| Format: | Article |
| Language: | English |
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Wiley
2017-06-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1880427616301375 |
| _version_ | 1818943335966965760 |
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| author | Paul Chun Yih Lim Joseph Jia Hong Toh Julian Kenrick Xing Yuan Loh Edward Chun Yi Lee Daniel Thuan Tee Chong Boon Yew Tan Kah Leng Ho Chi Keong Ching Wee Siong Teo |
| author_facet | Paul Chun Yih Lim Joseph Jia Hong Toh Julian Kenrick Xing Yuan Loh Edward Chun Yi Lee Daniel Thuan Tee Chong Boon Yew Tan Kah Leng Ho Chi Keong Ching Wee Siong Teo |
| author_sort | Paul Chun Yih Lim |
| collection | DOAJ |
| description | Background: Percutaneous transcatheter radiofrequency ablation of atrial fibrillation with remote controlled magnetic navigation (RMN) has been shown to reduce radiation exposure to patients and physicians compared with conventional manual (MAN) ablation techniques.
Methods: Catheter ablation for atrial fibrillation was performed utilizing RMN in 214 consecutive patients and MAN ablation techniques in 229 patients. We compared the fluoroscopy and procedural times between RMN and MAN catheter ablation of atrial fibrillation. Secondary objectives included comparing acute procedural success and short-term complication rates between both ablation strategies.
Results: Fluoroscopy time was significantly shorter in the RMN group than the MAN group (53.5±30.1 vs 68.1±27.6 min, respectively; p<0.01); however, the total procedural time was longer in the RMN group (280.2±74.4 min vs 213.1±64.75, respectively; p>0.001). Further subgroup analysis of the most recent 50 ablations each from the RMN and MAN groups, to attenuate the RMN learning curve effect, showed an even greater difference in fluoroscopy time (RMN vs MAN: 53.5±30.1 vs 68.1±27.6 min), though a consistently longer procedure time with RMN (249.5±65.5 vs 186.3±65.6 min, respectively). The acute procedural success rate was comparable between the groups (98.6% vs 95.6%, respectively; p=0.07). The rates of acute complications were similar in both groups (2.3% vs 4.8%, respectively; p=0.16).
Conclusions: In radiofrequency ablation of atrial fibrillation, RMN appears to significantly reduce fluoroscopy time compared with conventional MAN ablation, though at a cost of increased total procedural time, with comparable acute success rates and safety profile. A reduction in procedure and fluoroscopy times is possible with gaining experience. |
| first_indexed | 2024-12-20T07:25:42Z |
| format | Article |
| id | doaj.art-a42a1b089ae84f1fb6ed9d592440a84c |
| institution | Directory Open Access Journal |
| issn | 1880-4276 |
| language | English |
| last_indexed | 2024-12-20T07:25:42Z |
| publishDate | 2017-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-a42a1b089ae84f1fb6ed9d592440a84c2022-12-21T19:48:32ZengWileyJournal of Arrhythmia1880-42762017-06-0133316717110.1016/j.joa.2016.08.007Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reductionPaul Chun Yih LimJoseph Jia Hong TohJulian Kenrick Xing Yuan LohEdward Chun Yi LeeDaniel Thuan Tee ChongBoon Yew TanKah Leng HoChi Keong ChingWee Siong TeoBackground: Percutaneous transcatheter radiofrequency ablation of atrial fibrillation with remote controlled magnetic navigation (RMN) has been shown to reduce radiation exposure to patients and physicians compared with conventional manual (MAN) ablation techniques. Methods: Catheter ablation for atrial fibrillation was performed utilizing RMN in 214 consecutive patients and MAN ablation techniques in 229 patients. We compared the fluoroscopy and procedural times between RMN and MAN catheter ablation of atrial fibrillation. Secondary objectives included comparing acute procedural success and short-term complication rates between both ablation strategies. Results: Fluoroscopy time was significantly shorter in the RMN group than the MAN group (53.5±30.1 vs 68.1±27.6 min, respectively; p<0.01); however, the total procedural time was longer in the RMN group (280.2±74.4 min vs 213.1±64.75, respectively; p>0.001). Further subgroup analysis of the most recent 50 ablations each from the RMN and MAN groups, to attenuate the RMN learning curve effect, showed an even greater difference in fluoroscopy time (RMN vs MAN: 53.5±30.1 vs 68.1±27.6 min), though a consistently longer procedure time with RMN (249.5±65.5 vs 186.3±65.6 min, respectively). The acute procedural success rate was comparable between the groups (98.6% vs 95.6%, respectively; p=0.07). The rates of acute complications were similar in both groups (2.3% vs 4.8%, respectively; p=0.16). Conclusions: In radiofrequency ablation of atrial fibrillation, RMN appears to significantly reduce fluoroscopy time compared with conventional MAN ablation, though at a cost of increased total procedural time, with comparable acute success rates and safety profile. A reduction in procedure and fluoroscopy times is possible with gaining experience.http://www.sciencedirect.com/science/article/pii/S1880427616301375Atrial fibrillationRemote magnetic navigation |
| spellingShingle | Paul Chun Yih Lim Joseph Jia Hong Toh Julian Kenrick Xing Yuan Loh Edward Chun Yi Lee Daniel Thuan Tee Chong Boon Yew Tan Kah Leng Ho Chi Keong Ching Wee Siong Teo Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction Journal of Arrhythmia Atrial fibrillation Remote magnetic navigation |
| title | Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction |
| title_full | Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction |
| title_fullStr | Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction |
| title_full_unstemmed | Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction |
| title_short | Remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation: Fluoroscopy reduction |
| title_sort | remote magnetic catheter navigation versus conventional ablation in atrial fibrillation ablation fluoroscopy reduction |
| topic | Atrial fibrillation Remote magnetic navigation |
| url | http://www.sciencedirect.com/science/article/pii/S1880427616301375 |
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