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29.08.2018 | Original Paper

Remote vs. conventional navigation for catheter ablation of atrial fibrillation: insights from prospective registry data

verfasst von: Jan-Hendrik van den Bruck, Arian Sultan, Jakob Lüker, Dierk Thomas, Stephan Willems, Kai Weinmann, Malte Kuniss, Matthias Hochadel, Jochen Senges, Dietrich Andresen, Johannes Brachmann, Karl-Heinz Kuck, Roland Tilz, Daniel Steven

Erschienen in: Clinical Research in Cardiology | Ausgabe 3/2019

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Abstract

Background

Robotic (RNS) or magnetic navigation systems (MNS) are available for remotely performed catheter ablation for atrial fibrillation (AF).

Objective

The present study compares remotely assisted catheter navigation (RAN) to standard manual navigation (SMN) and both systems amongst each other.

Methods

The analysis is based on a sub-cohort enrolled by five hospitals from the multicenter German ablation Registry.

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

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.

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Titel: Remote vs. conventional navigation for catheter ablation of atrial fibrillation: insights from prospective registry data
verfasst von: Jan-Hendrik van den Bruck
Arian Sultan
Jakob Lüker
Dierk Thomas
Stephan Willems
Kai Weinmann
Malte Kuniss
Matthias Hochadel
Jochen Senges
Dietrich Andresen
Johannes Brachmann
Karl-Heinz Kuck
Roland Tilz
Daniel Steven
Publikationsdatum: 29.08.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 3/2019
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1356-6

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Remote vs. conventional navigation for catheter ablation of atrial fibrillation: insights from prospective registry data

Abstract

Background

Objective

Methods

Results

Conclusion

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Objective

Methods

Results

Conclusion

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