title: Flutter ablation with remote magnetic navigation: comparison between the 8-mm tip, the irrigated tip and a manual approach.
abstract: BACKGROUND
  Remote magnetic navigated ablation has proven its feasibility in a large group of arrhythmias. Until now only scarce data are available on the use for atrial flutter. In this study we compared remote magnetic navigation (RMN), using non-irrigated and irrigated tip catheters, to manual radiofrequency ablation for ablating typical atrial flutter.
  
  
  METHODS
  The 3 study groups consisted of 17 patients treated with RMN 8-mm tip; 14 patients with RMN irrigated tip; and 24 patients with a manual 8-mm tip. The primary outcome was the number of patients in whom bidirectional isthmus block could be obtained with < or = 15 applications. Secondary end points were the median number of applications needed, the need to switch to a manual irrigated tip catheter, the procedural and fluoroscopy times.
  
  
  RESULTS
  There was no significant difference in the primary end point (RMN 8 mm-tip group: 59%, RMN irrigated tip group: 64% and manual group: 83%). The median number of applications needed to obtain block was higher in the RMN groups compared to the manual group. In 5 patients from the RMN 8-mm tip group, 1 in the RMN irrigated tip group and 1 in the manual group, a switch to a manually irrigated tip catheter was performed.There was no difference in fluoroscopy time, but procedural time was significantly longer in the RMN groups compared to the manual group (P= 0.03).
  
  
  CONCLUSIONS
  The use of magnetic navigation for the ablation of atrial flutter is feasible but not superior to a manual approach. There was no difference concerning the primary end point of acute success within 15 applications. Overall, more applications were needed and procedure times were longer with RMN but RMN with the irrigating tip is promising.
authors: Department of Cardiology, Thoraxcentre, Erasmus MC, Rotterdam, the Netherlands. wim.anne1@gmail.com
authors: Wim
authors: W
authors: Anné
authors: Bruno
authors: B
authors: Schwagten
authors: Petter
authors: P
authors: Janse
authors: Tamas
authors: T
authors: Bauernfeind
authors: Yves
authors: Y
authors: Van Belle
authors: Natasja
authors: N
authors: De Groot
authors: Paul
authors: P
authors: Knops
authors: Luc
authors: L
authors: Jordaens
authors: Tamas
authors: T
authors: Szili-Torok
mesh_terms: D001282:Atrial Flutter / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D057785:Catheters; D004867:Equipment Design; D005240:Feasibility Studies; D006801:Humans; D012086:Reoperation