title: Mapping and ablation of ventricular arrhythmias with magnetic navigation: comparison between 4- and 8-mm catheter tips.
abstract: BACKGROUND
  Remote magnetic navigation (RMN) has been reported as an effective and safe tool to overcome the need for advanced operator skill in the treatment of complex arrhythmias. We report a series of patients undergoing radiofrequency catheter ablation of ventricular arrhythmias (VAs) using RMN with either a 4-mm catheter tip or an 8-mm catheter tip at four different centers.
  
  
  METHODS
  Sixty-five patients with clinical and symptomatic history of Vas were included. Two different magnetic catheters were used to deliver radiofrequency applications remotely. When ablation with the RMN catheters failed, a manual irrigated catheter was used to eliminate the VAs. Post-ablation pacing maneuvers were utilized to verify the inducibility of Vas.
  
  
  RESULTS
  Twenty-eight patients (43%) had ischemic cardiomyopathy [coronary artery disease (CAD)], 16 patients (25%) had non-ischemic cardiomyopathy [idiopathic dilated cardiomyopathy (IDC)], and 21 patients (32%) had structurally normal hearts (SNH) or right ventricle outflow tract tachycardia (RVOT). In patients with structural heart disease (CAD, IDC), success was achieved in 22% with the 4-mm catheter tip and in 59% with the 8-mm catheter tip (p = 0.014). In patients with SNH/RVOT, success was achieved in 85% with the 4-mm catheter tip and in 87% with the 8-mm catheter tip (p = 1.00).
  
  
  CONCLUSIONS
  Our findings showed that, with RMN, there is an increased success related to the catheter tip utilized. However, in patients with right ventricular outflow origin, the standard 4-mm tip provided adequate lesions for successful ablation in most patients.
authors.affiliation: Texas Cardiac Arrhythmia Institute, St David's Medical Center, Austin, TX, USA.
authors.forename: Luigi
authors.initials: L
authors.lastname: Di Biase
authors.forename: J David
authors.initials: JD
authors.lastname: Burkhardt
authors.forename: Dhanunjaya
authors.initials: D
authors.lastname: Lakkireddy
authors.forename: Jayasree
authors.initials: J
authors.lastname: Pillarisetti
authors.forename: Esam Nuri
authors.initials: EN
authors.lastname: Baryun
authors.forename: Mazda
authors.initials: M
authors.lastname: Biria
authors.forename: Rodney
authors.initials: R
authors.lastname: Horton
authors.forename: Javier
authors.initials: J
authors.lastname: Sanchez
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.forename: Shane
authors.initials: S
authors.lastname: Bailey
authors.forename: Salwa
authors.initials: S
authors.lastname: Beheiry
authors.forename: Richard
authors.initials: R
authors.lastname: Hongo
authors.forename: Steven
authors.initials: S
authors.lastname: Hao
authors.forename: Gery
authors.initials: G
authors.lastname: Tomassoni
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: D018780:Body Surface Potential Mapping / Q000295:instrumentation*; D017115:Catheter Ablation / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D008280:Magnetics / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000601:surgery*; D014159:Transducers; D016896:Treatment Outcome