title: Remote Magnetic versus Manual Navigation for Radiofrequency Ablation of Paroxysmal Atrial Fibrillation: Long-Term, Controlled Data in a Large Cohort.
abstract: Purpose.We aimed to study long-term outcome after pulmonary vein isolation (PVI) guided by remote magnetic navigation (RMN) and provided comparative data to outcome after manual navigation (MAN).Methods.Three hundred thirty-six patients with symptomatic paroxysmal AF underwent PVI by irrigated point-by-point radiofrequency (RF) ablation (RMN,n= 114 versus MAN,n= 222). Patients were followed up with symptom guided rhythm monitoring for a period up to 43 months. The end point of the study was freedom from repeat ablation after a single procedure and without antiarrhythmic drug treatment (ADT).Results.At the end of follow-up (median 26.3 months), freedom from repeat ablation was comparable between RMN and MAN (70.9% versus 69.5%,p= 0.61). At repeat, mean number of reconnected veins was 2.4 ± 1.2 in RMN versus 2.6 ± 1.0 in MAN (p= 0.08). The majority of repeat procedures occurred during the first year (82.1% in RMN versus 78.5% in MAN;p= 0.74).Conclusion.On the long term (up to 3 years) and in a large cohort of patients with paroxysmal AF, RMN-guided PVI is as effective as MAN guided PVI. In both strategies the majority of repeat procedures occurred during the first year after index procedure.
authors.affiliation: Department of Cardiology, St. Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium.
authors.forename: Vikas
authors.identifier: 0000-0003-1554-5516
authors.initials: V
authors.lastname: Kataria
authors.affiliation: Department of Cardiology, St. Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Berte
authors.affiliation: Department of Cardiology, St. Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium.
authors.forename: Yves
authors.initials: Y
authors.lastname: Vandekerckhove
authors.affiliation: Department of Cardiology, St. Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium.
authors.forename: Rene
authors.initials: R
authors.lastname: Tavernier
authors.affiliation: Department of Cardiology, St. Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium; University Hospital of Ghent, Ghent, Belgium.
authors.forename: Mattias
authors.identifier: 0000-0001-8451-0013
authors.initials: M
authors.lastname: Duytschaever
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery; D017115:Catheter Ablation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology* / Q000528:radiation effects / Q000601:surgery; D016896:Treatment Outcome