Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020, 164(4):387-393 | DOI: 10.5507/bp.2019.045

Comparison of atrial fibrillation ablation efficacy using remote magnetic navigation vs. manual navigation with contact-force control

Jiri Jeza,b, Tomasz Jadczyka,c, Frantisek Lehara,b, Martin Pesla,b,d, Tomas Kulika, Silvie Belaskovae, Filip Souceka, Guido Caluoria,f, Wojciech Wojakowskic, Zdenek Stareka,b
a International Clinical Research Center, Interventional Cardiac Electrophysiology, St. Anne's University Hospital Brno, Czech Republic
b Department of Cardiovascular Diseases, Faculty of Medicine, Masaryk University, Brno, Czech Republic
c Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
d Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
e Biostatistics, International Clinical Research Center, St. Anne's University Hospital Brno, Brno, Czech Republic
f CEITEC, Masaryk University, Brno, Czech Republic

Aims: This study aims to compare procedural parameters and clinical efficacy of remote magnetic navigation (RMN) vs. manual navigation (MAN) approach for radiofrequency ablation (RFA) in patients with atrial fibrillation (AF).

Methods: 146 patients with AF were enrolled in the study. In the RMN group (n=57), patients were treated with the CARTO® 3 in combination with the Niobe ES system. In the MAN group (n=89), ablation was performed with the EnSite Velocity and TactiCath™ Quartz catheter with direct contact force measurement. Procedural time, ablation time, fluoroscopy time, radiation dose and ablation counts were measured and compared between the groups. Recurrence of AF was evaluated after 6 months of follow-up.

Results: Mean procedure times (236.87±64.31 vs. 147.22±45.19 min, P<0.05), counts of RF applications (74.30±24.77 vs. 49.15±20.33, P<0.05) and total RFA times (4323.39±1426.69 vs. 2780.53±1157.85 s, P<0.05) were all significantly higher in the RMN than in the MAN group, respectively. In the same order, mean X-ray dose (9722.6±7507.4 vs. 8087.9±6051.5 mGy/cm2, P=0.12) and mean total X-ray exposure time (8.07±4.20 vs. 9.54±5.47 min, P=0.08) were not statistically different. At 6-month follow-up, freedom from AF was similar in RMN and MAN group for paroxysmal (60.8% and 73%, respectively, P=0.42) and persistent AF (69.6% and 75.0%, respectively, P=0.77).

Conclusions: Due to the fact that mid-term clinical outcomes showed no significant differences in AF recurrences between groups and manual ablation strategy provided more favorable results regarding acute procedural parameters, we can conclude that the remote magnetic navigation is not superior to the manual approach.

Keywords: atrial fibrillation, radiofrequency ablation, electro-anatomical mapping, remote magnetic navigation, contact-force technology

Received: May 20, 2019; Revised: July 19, 2019; Accepted: September 4, 2019; Prepublished online: October 10, 2019; Published: December 15, 2020  Show citation

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Jez, J., Jadczyk, T., Lehar, F., Pesl, M., Kulik, T., Belaskova, S., ... Starek, Z. (2020). Comparison of atrial fibrillation ablation efficacy using remote magnetic navigation vs. manual navigation with contact-force control. Biomedical papers, 164(4), 387-393. doi: 10.5507/bp.2019.045
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