Initial Experience With Remote Catheter Ablation Using a Novel Magnetic Navigation System: Magnetic Remote Catheter Ablation.
Ernst, Sabine MD; Ouyang, Feifan MD; Linder, Christian MD; Hertting, Klaus MD; Stahl, Fabian MD; Chun, Julian MD; Hachiya, Hitoshi MD; Bansch, Dietmar MD; Antz, Matthias MD; Kuck, Karl-Heinz MD
109(12):1472-1475, March 30, 2004.
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Background-: Catheters are typically stiff and incorporate a pull-wire mechanism to allow tip deflection. While standing at the patient's side, the operator manually navigates the catheter in the heart using fluoroscopic guidance.
Methods and Results-: A total of 42 patients (32 female; mean age, 55 /-15 years) underwent ablation of common-type (slow/fast) or uncommon-type (slow/slow) atrioventricular nodal reentrant tachycardia (AVNRT) with the use of the magnetic navigation system Niobe (Stereotaxis, Inc). It consists of 2 computer-controlled permanent magnets located on opposite sides of the patient, which create a steerable external magnetic field (0.08 T). A small magnet embedded in the catheter tip causes the catheter to align and to be steered by the external magnetic field. A motor drive advances or retracts the catheter, enabling complete remote navigation. Radiofrequency current was applied with the use of a remote-controlled 4-mm, solid-tip, magnetic navigation-enabled catheter (55[degrees]C, maximum 40 W, 60 seconds) in all patients. The investigators, who were situated in the control room, performed the ablation using a mean of 7.2 /-4.7 radiofrequency current applications (mean fluoroscopy time, 8.9 /-6.2 minutes; procedure duration, 145 /-43 minutes). Slow pathway ablation was achieved in 15 patients, whereas slow pathway modulation was the end point in the remaining patients. There were no complications.
Conclusions-: The Niobe magnetic navigation system is a new platform technology allowing remote-controlled navigation of an ablation catheter. In conjunction with a motor drive unit, this system was used successfully to perform completely remote-controlled mapping and ablation in patients with AVNRT.
(C) 2004 American Heart Association, Inc.