title: Remote magnetic navigation for ablation of typical atrial flutter: Long-term results.
abstract: OBJECTIVE
  Remote magnetic navigation has proved to be effective in the ablation of most supraventricular and ventricular arrhythmias. Initial studies reported worse results with this system compared to conventional ablation for atrial flutter. The aim of this study was to assess the acute and long-term success of atrial flutter ablation with remote magnetic navigation and to retrospectively compare the results obtained with an 8-mm tip catheter versus an irrigated catheter.
  
  
  METHODS
  We studied 38 consecutive patients, mean age 61 ± 15 years, 28 male, who underwent ablation of typical atrial flutter with the Niobe II remote magnetic navigation system (Stereotaxis). Ablation was performed with an 8-mm tip catheter in 17 patients and with an irrigated-tip catheter in 21 patients. Acute success was defined as the presence of bidirectional isthmus block, and long-term success as absence of symptoms and atrial flutter during Holter monitoring.
  
  
  RESULTS
  Bidirectional isthmus block was achieved in 37 patients (97%), and the success rate was similar in both groups. Total procedure time was not significantly different between the groups but fluoroscopy time was shorter in the irrigated tip group (13.4 ± 3.7 min vs. 6 ± 4.4 min; p<0.01). The number of applications and total radiofrequency time did not differ. There were no complications. During a follow-up of 32 ± 19 months there were two relapses, one in each group.
  
  
  CONCLUSIONS
  The Niobe II remote control system for ablation of typical atrial flutter is safe and effective in both the short and long term. The 8-mm and irrigated-tip catheters showed similar safety and efficacy.
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal. Electronic address: leonor.parreira@gmail.com.
authors.forename: Leonor
authors.initials: L
authors.lastname: Parreira
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal.
authors.forename: Diogo
authors.initials: D
authors.lastname: Cavaco
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Carmo
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal.
authors.forename: Katya
authors.initials: K
authors.lastname: Reis-Santos
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Quaresma
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal.
authors.forename: Tiago
authors.initials: T
authors.lastname: Teixeira
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Marques
authors.affiliation: Centro do Ritmo Cardíaco, Hospital da Luz, Lisboa, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Adragão
mesh_terms: D001282:Atrial Flutter / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013238:Stereotaxic Techniques; D013997:Time Factors
keywords: Ablação por radiofrequência; Estereotaxia; Flutter auricular típico; Navegação magnética; Radiofrequency ablation; Remote magnetic navigation; Stereotaxis; Typical atrial flutter