Remote vs. conventional navigation for catheter ablation of atrial fibrillation: insights from prospective registry data.
Atrial Fibrillation
/ physiopathology
Catheter Ablation
/ methods
Equipment Design
Female
Fluoroscopy
/ methods
Follow-Up Studies
Heart Conduction System
/ physiopathology
Heart Rate
/ physiology
Humans
Male
Middle Aged
Prospective Studies
Registries
Robotics
/ instrumentation
Surgery, Computer-Assisted
/ instrumentation
Treatment Outcome
AF ablation registry
Catheter ablation of AF
Remote navigation systems
Journal
Clinical research in cardiology : official journal of the German Cardiac Society
ISSN: 1861-0692
Titre abrégé: Clin Res Cardiol
Pays: Germany
ID NLM: 101264123
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
17
04
2018
accepted:
13
08
2018
pubmed:
31
8
2018
medline:
29
5
2019
entrez:
31
8
2018
Statut:
ppublish
Résumé
Robotic (RNS) or magnetic navigation systems (MNS) are available for remotely performed catheter ablation for atrial fibrillation (AF). The present study compares remotely assisted catheter navigation (RAN) to standard manual navigation (SMN) and both systems amongst each other. The analysis is based on a sub-cohort enrolled by five hospitals from the multicenter German ablation Registry. Out of 2442 patients receiving catheter ablation of AF, 267 (age 61.4 ± 10.4, 69.7% male) were treated using RAN (RNS n = 187, 7.7% vs. MNS n = 80, 3.3%). Fluoroscopy time [RNS median 17 (IQR 12-25) min vs. MNS 22 (16-32) min; p < 0.001] and procedure duration [RNS 180 (145-220) min vs. MNS 265 (210-305) min; p < 0.001] were significantly different. Comparing RAN (11%) to SMN (89%) fluoroscopy time (RAN 19 (13-27) min, vs. SMN 25 (16-40) min; p < 0.001), energy delivery (RAN 3168 (2280-3840) s vs. SMN 2640 (IQR 1799-3900) s; p = 0.008) and procedure duration [RAN 195 (150-255) min vs. SMN 150 (120-150) min; p = 0.001] differed significantly. In terms of acute and 12 months outcome, no differences were seen between the two systems or in comparison to SMN. AF ablation can be performed safely, with high acute success rates using RAN. RNS results in less fluoroscopy burden and shorter procedure durations. Compared to SMN, a reduced fluoroscopy burden, prolonged procedure and ablation duration were observed using RAN. Overall, the number of RAN procedures is small suggesting low impact on clinical routine of AF ablation.
Sections du résumé
BACKGROUND
BACKGROUND
Robotic (RNS) or magnetic navigation systems (MNS) are available for remotely performed catheter ablation for atrial fibrillation (AF).
OBJECTIVE
OBJECTIVE
The present study compares remotely assisted catheter navigation (RAN) to standard manual navigation (SMN) and both systems amongst each other.
METHODS
METHODS
The analysis is based on a sub-cohort enrolled by five hospitals from the multicenter German ablation Registry.
RESULTS
RESULTS
Out of 2442 patients receiving catheter ablation of AF, 267 (age 61.4 ± 10.4, 69.7% male) were treated using RAN (RNS n = 187, 7.7% vs. MNS n = 80, 3.3%). Fluoroscopy time [RNS median 17 (IQR 12-25) min vs. MNS 22 (16-32) min; p < 0.001] and procedure duration [RNS 180 (145-220) min vs. MNS 265 (210-305) min; p < 0.001] were significantly different. Comparing RAN (11%) to SMN (89%) fluoroscopy time (RAN 19 (13-27) min, vs. SMN 25 (16-40) min; p < 0.001), energy delivery (RAN 3168 (2280-3840) s vs. SMN 2640 (IQR 1799-3900) s; p = 0.008) and procedure duration [RAN 195 (150-255) min vs. SMN 150 (120-150) min; p = 0.001] differed significantly. In terms of acute and 12 months outcome, no differences were seen between the two systems or in comparison to SMN.
CONCLUSION
CONCLUSIONS
AF ablation can be performed safely, with high acute success rates using RAN. RNS results in less fluoroscopy burden and shorter procedure durations. Compared to SMN, a reduced fluoroscopy burden, prolonged procedure and ablation duration were observed using RAN. Overall, the number of RAN procedures is small suggesting low impact on clinical routine of AF ablation.
Identifiants
pubmed: 30159751
doi: 10.1007/s00392-018-1356-6
pii: 10.1007/s00392-018-1356-6
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
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