Abstract 3509: Remote Magnetic Navigation System: Initial Experience in Pulmonary Vein Isolation
Introduction: We assessed feasibility of remote wide circumferential pulmonary vein ablation (PVA) using magnetic navigation in patients with atrial fibrillation (AF).
Methods: 35 patients underwent PVAI for symptomatic and drug refractory AF using the NIOBE II remote magnetic system (Stereotaxis Inc., St. Louis, Missouri). Ablation was performed with a 4-mm tip, magnetic catheter (50°C, maximum 50 W, 60 s). The catheter tip was guided by a uniform magnetic field (0.08-T), and a motor drive (Cardiodrive unit, Stereotaxis Inc.). Left atrium maps were created using an integrated CARTO RMT system (Biosense Webster, Inc., Diamond Bar, CA ). End point of the ablation was electrical disconnection of the pulmonary veins. In 14 patients the coordinate approach to navigate the catheter was used while the wand approach was used in the remaining 21 patients.
Results: Using the remote ablation system the pulmonary veins could be electrically isolated in only 2 patients. In the remaining 22 patients there were no significant changes in pre and post ablation intracardiac electrograms. With the coordinate approach, the target location was reached by the catheter in only 62% of the selected sites, while by using the wand approach all sites could be reached (100%). Catheter instability with respiration was evident in 4 patients. Charring on the ablation catheter tip was seen in 11 (31%) of the 35 cases. No procedural complications were observed.
Conclusion: Remote navigation using magnetic system is a feasible and promising technique. The wand approach may allow a better catheter navigation to the determined location. Further refinements of the system are required for its use as a successful ablation modality for AF.