stxs - Abstract related to PR release today. Huge improvement in efficacy and especially safety. Manual VT ablation has been considered a niche procedure with a very high major complication rate and most patients get referred ICDs for that reason.
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Usefulness of the magnetic navigation system in ablation of ventricular tachycardia: acute and follow-up results compared to manual ablation
Authors:
B. Schwagten (Rotterdam /Netherlands), T. Bauernfeind (Rotterdam /Netherlands), N. De Groot (Rotterdam /Netherlands), Y. Van Belle (Rotterdam /Netherlands), D. Haitsma (Rotterdam /Netherlands), L. Jordaens (Rotterdam /Netherlands), T. Szili-Torok (Rotterdam /Netherlands)
Topic(s):
Ventricular arrhythmias
Citation:
European Heart Journal ( 2010 ) 31 ( Abstract Supplement ), 932
Background: Radiofrequency catheter ablation of ventricular tachycardia (VT) remains a challenging task. Recent studies confirm the distinctive advantages of the magnetic navigation system (MNS) (Niobe, Stereotaxis, St. Louis, MO, USA) such as procedural safety, catheter maneuverability and reproducibility of catheter position. The aim of this study was to evaluate the acute and late outcome of VT ablation using the MNS as compared to manual ablation.
Methods: Ablation data of 64 consecutive pts with ventricular tachycardia treated with catheter ablation at our center were analyzed as two groups. MNS was used in combination with the CARTO RMT (Biosense-Webster Inc., Diamond Bar, CA, USA) system for catheter navigation, mapping and ablation for Group 1. Group 2 were ablated using either the CARTO XP or the EnSite NavX system (St. Jude Medical, St Paul, MN, USA) and a manual ablation catheter. Success rate, complications, and procedure, fluoroscopy and ablation times were recorded.
Results: Thirty-seven procedures were performed in Group 1 vs. 27 in Group 2. Right ventricular (RV) and left ventricular (LV) VTs were equally distributed between the two groups. Acute success was achieved in 36 (97%) vs. 22 (81%) pts (p = 0.03). Mean pt age was 51±13 vs 50±17 years (NS), procedural time was 170±61 vs 228±99 minutes (p<0.01), median number of applications was 8 (range 1 – 67) vs 13 (range 1 – 95) (NS), mean fluoroscopy time was 25±19 vs 57±33 minutes (p<0.001). No major complications occurred in the MNS group vs 1 cardiac tamponade leading to patient demise in the manual group. After a mean follow-up of 12±5 vs 8±6 months (NS), VT recurred in 5 pts (14%) in Group 1 vs 11 pts (50%) in Group 2 (p<0.01).
Conclusions: The use of MNS offers major advantages for ablation of VTs: it is associated with higher acute success rate, reduced procedure time, fluoroscopy exposure and complications. Less recurrences of VT were observed after MNS procedures than after manual ablation during the follow-up. |
