title: The magnetic navigation system allows safety and high efficacy for ablation of arrhythmias.
abstract: OBJECTIVE
  We aimed to evaluate the safety and long-term efficacy of the magnetic navigation system (MNS) in a large number of patients. The MNS has the potential for improving safety and efficacy based on atraumatic catheter design and superior navigation capabilities.
  
  
  RESULTS
  In this study, 610 consecutive patients underwent ablation. Patients were divided into two age- and sex-matched groups. Ablations were performed either using MNS (group MNS, 292) or conventional manual ablation [group manual navigation (MAN), 318]. The following parameters were analysed: acute success rate, fluoroscopy time, procedure time, complications [major: pericardial tamponade, permanent atrioventricular (AV) block, major bleeding, and death; minor: minor bleeding and temporary AV block]. Recurrence rate was assessed during follow-up (15±9.5 months). Subgroup analysis was performed for the following groups: atrial fibrillation, isthmus dependent and atypical atrial flutter, atrial tachycardia, AV nodal re-entrant tachycardia, circus movement tachycardia, and ventricular tachycardia (VT). Magnetic navigation system was associated with less major complications (0.34 vs. 3.2%, P=0.01). The total numbers of complications were lower in group MNS (4.5 vs. 10%, P=0.005). Magnetic navigation system was equally effective as MAN in acute success rate for overall groups (92 vs. 94%, P=ns). Magnetic navigation system was more successful for VTs (93 vs. 72%, P<0.05). Less fluoroscopy was used in group MNS (30±20 vs. 35±25 min, P<0.01). There were no differences in procedure times and recurrence rates for the overall groups (168±67 vs. 159±75 min, P=ns; 14 vs. 11%, P=ns; respectively).
  
  
  CONCLUSIONS
  Our data suggest that the use of MNS improves safety without compromising efficiency of ablations. Magnetic navigation system is more effective than manual ablation for VTs.
authors.affiliation: Department of Cardiology, Thoraxcenter, Clinical Electrophysiology, Erasmus MC, Postbus 2040, S Gravendijkwal 230, Kamer BD416, 3000 CA Rotterdam, The Netherlands.
authors.forename: Tamas
authors.initials: T
authors.lastname: Bauernfeind
authors.forename: Ferdi
authors.initials: F
authors.lastname: Akca
authors.forename: Bruno
authors.initials: B
authors.lastname: Schwagten
authors.forename: Natasja
authors.initials: N
authors.lastname: de Groot
authors.forename: Yves
authors.initials: Y
authors.lastname: Van Belle
authors.forename: Suzanne
authors.initials: S
authors.lastname: Valk
authors.forename: Barbara
authors.initials: B
authors.lastname: Ujvari
authors.forename: Luc
authors.initials: L
authors.lastname: Jordaens
authors.forename: Tamas
authors.initials: T
authors.lastname: Szili-Torok
mesh_terms: D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000601:surgery*; D054537:Atrioventricular Block / Q000209:etiology; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000209:etiology; D012042:Registries; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome