Initial clinical experience with the new irrigated tip magnetic catheter for ablation of scar-related sustained ventricular tachycardia: a small case series.
BACKGROUND
A remote magnetic navigation system (MNS) has been used with a nonirrigated magnetic catheter for ablation of some supraventricular and ventricular arrhythmias. However, the irrigated tip catheter has not been evaluated.


OBJECTIVE
To evaluate the feasibility and efficiency of the newly available irrigated tip magnetic catheter for radiofrequency ablation (RF) of electrical storm due to scar-related ventricular tachycardia (VT) in patients with ischemic heart disease.


METHODS
Between January and March 2008, a total of 4 consecutive patients (4 men, mean age 67.7 years) with electrical storm who had an implantable cardioverter defibrillator underwent radiofrequency ablation using a remote MNS and the new magnetic irrigated catheter.


RESULTS
Five ablation procedures were performed in study patients. Acute success, defined as noninducibility of any monomorphic VT, was obtained in 3 patients. In 1 patient, a nonclinical VT remained inducible. A monomorphic VT corresponding to clinical VT with the median (range) cycle length of 485 (440-580) ms was induced in all patients. The duration of ablation was 2,273 (985-3087) seconds, with median total procedure and fluoroscopy times of 135 (100-150) minutes and 6.5 (5-9) minutes, respectively. One recurrence occurred 1 week after ablation, which was ablated successfully in the second session. No complication was observed after ablation. During mean follow-up of 4.2 months, all patients were in sinus rhythm, they received no ICD therapy, and no mortality occurred.


CONCLUSIONS
Irrigated ablation of scar-related ventricular tachycardia guided by remote MNS is a feasible and effective modality for management of the electrical storm in patients with ischemic cardiomyopathy with minimal radiation exposure.
Haghjoo
Majid
M
Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany.
Hindricks
Gerhard
G
Bode
Kerstin
K
Piorkowski
Christopher
C
Bollmann
Andreas
A
Arya
Arash
A
D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods*; D002921:Cicatrix / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008280:Magnetics / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D007507:Therapeutic Irrigation