title: Safety and feasibility of single-catheter ablation using remote magnetic navigation for treatment of slow-fast atrioventricular nodal reentrant tachycardia compared to conventional ablation strategies.
abstract: OBJECTIVE
  Ablation of atrioventricular nodal re-entrant tachycardia (AVNRT) is a highly effective procedure both with radiofrequency (RF) and cryoenergy (CE). Conventionally, it requires several diagnostic catheters and hospital admission. This study assessed the safety and efficacy of a highly simplified approach using the magnetic navigation system (MNS) compared to CE and manual RF ablation (MAN).
  
  
  RESULTS
  In the MNS group a single magnetic-guided quadripolar catheter was inserted through the internal jugular vein to perform ablation. In the CE group cryomapping preceded ablation and for MAN procedures conventional ablation was performed. The following parameters were analysed: success- and recurrence rate, procedure-, fluoroscopy- and total application time. In total 69 eligible patients were treated with MNS (n = 26), CE (n = 25) and MAN (n = 16). The success rates were 100%, 100% and 94%, respectively (p = ns). The mean procedural time was 83 +/- 25 min for MNS, 117 +/- 47 min for CE and 117 +/- 55 min for MAN (P < 0.01). Total radiation time was significantly lower for MNS [0.0 min (IQR 0.0-0.0)] compared to CE [15.1 min (IQR 9.1-23.8), P < 0.001] and MAN [17.5 min (IQR 7.0-31.3), P < 0.001]. The total application time was comparable for both RF groups: 357 +/- 315 s (MNS) vs 204 +/- 177 s (MAN) (P = 0.14). No major adverse events occurred. After 3 months follow-up similar PR intervals were recorded for all patients. During a follow-up of 26 +/- 5 months recurrence rates were 3.8%, 4.0% and 6.3%, respectively, for each group.
  
  
  CONCLUSIONS
  The MNS-guided single-catheter approach is a feasible and safe technique for the treatment of patients with typical AVNRT.
authors.affiliation: Dept. of Clinical Electrophysiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Ferdi
authors.initials: F
authors.lastname: Akca
authors.affiliation: Dept. of Clinical Electrophysiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Bruno
authors.initials: B
authors.lastname: Schwagten
authors.affiliation: Dept. of Clinical Electrophysiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Dominic A J
authors.initials: DA
authors.lastname: Theuns
authors.affiliation: Dept. of Clinical Electrophysiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: Takens
authors.affiliation: Dept. of Clinical Electrophysiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Musters
authors.affiliation: Dept. of Clinical Electrophysiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Tamas
authors.initials: T
authors.lastname: Szili-Torok
mesh_terms: D017115:Catheter Ablation / Q000295:instrumentation*; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008280:Magnetics / Q000295:instrumentation*; D059346:Magnets; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome