Remote-controlled magnetic ablation of a right anterolateral accessory pathway - the superior caval vein approach.
OBJECTIVE
An 18-year old male patient with recurrent supraventricular tachycardias was admitted for catheter ablation. Baseline ECG was consistent with right anterolateral accessory pathway (AP) conduction.


METHODS
The novel magnetic navigation system (MNS, Niobe Stereotaxis) in combination with a catheter advancer unit (Cardiodrive, Stereotaxis) allows a complete remote-controlled electrophysiologic study and ablation.


RESULTS
Despite accurate identification of the AP insertion site using the MNS, a stable catheter position was not achieved from the inferior caval vein. Therefore, the venous access was switched to the superior caval vein approach using the left subclavian vein. The same magnetic field vector now resulted in a perfectly stable catheter position, and application of radiofrequency current immediately blocked AP conduction.


CONCLUSIONS
This case demonstrates feasibility and safety of a complete remote-controlled ablation of a right-sided anterolateral accessory pathway using the superior approach in conjunction with the novel magnetic navigation system Niobe.
Chun
Julian Kyoung-Ryul
JK
II. Medical Department, St. Georg General Hospital, Lohmuehlenstr. 5, 20099 Hamburg, Germany.
Schmidt
Boris
B
Kuck
Karl-Heinz
KH
Ernst
Sabine
S
D000293:Adolescent; D017115:Catheter Ablation / Q000295:instrumentation*; D006801:Humans; D008280:Magnetics / Q000295:instrumentation*; D008297:Male; D012008:Recurrence; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014683:Vena Cava, Superior / Q000601:surgery; D014927:Wolff-Parkinson-White Syndrome / Q000150:complications / Q000175:diagnosis / Q000601:surgery*