title: A Comparison of Remote Magnetic Irrigated Tip Ablation versus Manual Catheter Irrigated Tip Catheter Ablation With and Without Force Sensing Feedback.
abstract: BACKGROUND
  Remote magnetic navigation (RMN) and contact force (CF) sensing technologies have been utilized in an effort to improve safety and efficacy of catheter ablation. A comparative analysis of the relative short- and long-term outcomes of AF patients has not been performed. As such, we comparatively evaluated the safety and efficacy of these technologies.
  
  
  METHODS
  A total of 627 patients who underwent catheter ablation with either a manual irrigated tip catheter: (312, 49.8%) or by RMN: (315, 50.2%) were included in this single-center cohort study. Patients treated with CF (59) were analyzed separately as well. One- and 3-year endpoints included death, HF hospitalization, stroke, TIA, and atrial flutter or AF recurrence.
  
  
  RESULTS
  Age averaged 65.1 ± 10.7 years and 64.1% male. One- and 3-year endpoints of death, HF hospitalization, stroke, TIA, and atrial flutter or AF recurrence were statistically similar between manual and RMN treated groups. Fluoroscopy times were significantly lower in the RMN group compared to the manual ablation group (8.47 ± 0.45 vs. 9.63 ± 4.06 minutes, P < 0.0001). CF guided patients had 1-year recurrence rate of AF/atrial flutter statistically identical to patients treated with RMN (36.8% vs. 38.6%; P = 1.00).
  
  
  CONCLUSIONS
  RMN results in outcomes similar to manual navigation. The addition of CF sensing catheters did not improve relative procedural outcome or safety profile in comparison to RMN guided ablation in this large observational study of AF ablation.
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: J Peter
authors.initials: JP
authors.lastname: Weiss
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: Heidi T
authors.initials: HT
authors.lastname: May
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: Tami L
authors.initials: TL
authors.lastname: Bair
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: Brian G
authors.initials: BG
authors.lastname: Crandall
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Cutler
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: John D
authors.initials: JD
authors.lastname: Day
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Osborn
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Mallender
authors.affiliation: Intermountain Medical Center, Intermountain Medical Center Heart Institute, Murray, Utah, USA.|Department of Internal Medicine, Stanford University, Palo Alto, California, USA.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation* / Q000379:methods*; D015331:Cohort Studies; D004867:Equipment Design / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D060328:Magnetic Phenomena; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D013238:Stereotaxic Techniques / Q000295:instrumentation; D016896:Treatment Outcome
keywords: atrial fibrillation; atrial fibrillation ablation; catheter ablation; remote magnetic navigation