title: Remote magnetic navigation for mapping and ablation of right and left ventricular outflow tract arrhythmias.
abstract: OBJECTIVE
  The aim of this study was to assess the efficacy and potential complications of a remote-controlled magnetic navigation system (Niobe II, Stereotaxis) for mapping and ablation of right or left ventricular outflow tract ventricular tachycardia or premature ventricular contractions.
  
  
  METHODS
  We studied 32 consecutive patients, mean age 43±11 years, 24 female. Mapping of the arrhythmia was performed using the CARTO RMT mapping system, remotely guided by the Niobe II. Radiofrequency ablation was performed at the site of earliest ventricular activation with pacemapping of at least 11/12 leads. Acute success was defined as suppression and non-inducibility of the arrhythmia after stimulation with isoprenaline. After a minimum 3-month follow-up, we assessed clinical success (absence of symptoms and suppression of the arrhythmia on Holter recording), defined as less than 50 premature ventricular contractions/24 hours.
  
  
  RESULTS
  The origin of the arrhythmia was in the right ventricular outflow tract in 28 patients (88%), in the left in three, and in the epicardium in one. Acute success was achieved in 26 patients (81%). Two patients underwent a second successful procedure, in one of which an epicardial approach was necessary. The overall clinical success rate, after two repeat procedures, was 88%. No complications occurred. There were two recurrences during a mean follow-up of 307±204 days.
  
  
  CONCLUSIONS
  The Niobe II remote control system for mapping and ablation of ventricular outflow tract arrhythmias is effective and safe, and provides precise mapping and a high success rate, with no complications.
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal. lparreira@netvisao.pt
authors.forename: Leonor
authors.initials: L
authors.lastname: Parreira
authors.forename: Diogo
authors.initials: D
authors.lastname: Cavaco
authors.forename: Katya
authors.initials: K
authors.lastname: Reis-Santos
authors.forename: Pedro
authors.initials: P
authors.lastname: Carmo
authors.forename: David
authors.initials: D
authors.lastname: Cabrita
authors.forename: Mauricio
authors.initials: M
authors.lastname: Scanavacca
authors.forename: Pedro
authors.initials: P
authors.lastname: Adragão
mesh_terms: D000328:Adult; D006348:Cardiac Surgical Procedures / Q000379:methods; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006352:Heart Ventricles; D006801:Humans; D060526:Magnetic Fields; D008297:Male; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*
keywords: Ablação por radiofrequência; Estereotaxia; Extrassístoles ventriculares; Navegação magnética; Premature ventricular contractions; Radiofrequency ablation; Remote magnetic navigation; Stereotaxis; Taquicardia ventricular; Ventricular tachycardia