title: Catheter ablation of atrial fibrillation using remote magnetic catheter navigation: a case-control study.
abstract: OBJECTIVE
  To compare the acute and the 6 month outcome of catheter ablation of atrial fibrillation (AF) using irrigated tip magnetic catheter and remote magnetic cathter navigation (RMN) with manual catheter navigation (MCN) in patients with paroxysmal and persistent AF.
  
  
  RESULTS
  In this retrospective analysis 356 patients (235 male, mean age: 57.9 ± 10.9 years) with AF (70.5%, paroxysmal) who underwent catheter ablation between August 2007 and May 2008 using either RMN (n = 70, 46 male, mean age: 57.9 ± 10.1 years, 50% paroxysmal) or MCN (n = 286, 189 male, mean age: 58.0 ± 13.9 years, 75.5% paroxysmal) were included. All patients completed an intensive follow-up strategy. Complete pulmonary vein isolation was achieved in 87.6 and 99.6% of patients in RMN and MCN groups, respectively (P < 0.05). The procedure, fluoroscopy, and radiofrequency application times were 223 ± 44 vs. 166 ± 52 min (P < 0.0001), 13.7 ± 7.8 vs. 34.5 ± 15.1 min (P < 0.0001), and 75.4 ± 20.9 vs. 53.2 ± 21.4 min (P < 0.0001) in RMN and MCN groups, respectively. Seven (10.0%) and 28 (9.8%) patients in RMN and MCN groups received antiarrhythmic medications during the follow-up (P = 0.96). All the patients completed the 6 month follow-up. Freedom from AF at 6 months was achieved in 57.8 and 66.4% of the patients in RMN and MCN groups, respectively (P = 0.196). In patients without previous AF catheter ablation procedure the freedom from AF at 6 months were 68.2 and 60.5% in the MCN and RMN groups, respectively (P = 0.36).
  
  
  CONCLUSIONS
  Catheter ablation using irrigated tip magnetic catheter and RMN is an effective and safe method for catheter ablation of AF. Compared to manual catheter navigation, the procedure and radiofrequency application times were longer and fluoroscopy time was shorter in the RMN group compared with the MCN group.
authors.affiliation: Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany. dr.arasharya@gmail.com
authors.forename: Arash
authors.initials: A
authors.lastname: Arya
authors.forename: Ruzbeh
authors.initials: R
authors.lastname: Zaker-Shahrak
authors.forename: Phillip
authors.initials: P
authors.lastname: Sommer
authors.forename: Andreas
authors.initials: A
authors.lastname: Bollmann
authors.forename: Ulrike
authors.initials: U
authors.lastname: Wetzel
authors.forename: Thomas
authors.initials: T
authors.lastname: Gaspar
authors.forename: Sergio
authors.initials: S
authors.lastname: Richter
authors.forename: Daniela
authors.initials: D
authors.lastname: Husser
authors.forename: Christopher
authors.initials: C
authors.lastname: Piorkowski
authors.forename: Gerhard
authors.initials: G
authors.lastname: Hindricks
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000601:surgery*; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000295:instrumentation / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome