Contact force sensing manual catheter versus remote magnetic navigation ablation of atrial fibrillation: a single-center comparison.

IF 1.4 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Heart and Vessels Pub Date : 2024-05-01 Epub Date: 2024-01-08 DOI:10.1007/s00380-023-02344-8

Simon Schlögl, Klaudia Stella Schlögl, Philipp Bengel, Helge Haarmann, Leonard Bergau, Eva Rasenack, Gerd Hasenfuss, Markus Zabel

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Abstract

Background: Data comparing remote magnetic catheter navigation (RMN) with manual catheter navigation in combination with contact force sensing (MCN-CF) ablation of atrial fibrillation (AF) is lacking. The primary aim of the present retrospective comparative study was to compare the outcome of RMN versus (vs.) MCN-CF ablation of AF with regards to AF recurrence. Secondary aim was to analyze periprocedural risk, ablation characteristics and repeat procedures.

Methods: We retrospectively analyzed 452 patients undergoing a total of 605 ablations of AF: 180 patients were ablated using RMN, 272 using MCN-CF.

Results: Except body mass index there was no significant difference between groups at baseline. After a mean 1.6 ± 1.6 years of follow-up and 1.3 ± 0.4 procedures, 81% of the patients in the MCN-CF group remained free of AF recurrence compared to 53% in the RMN group (P < 0.001). After analysis of 153 repeat ablations (83 MCN-RF vs. 70 RMN; P = 0.18), there was a significantly higher reconnection rate of pulmonary veins after RMN ablation (P < 0.001). In multivariable Cox-regression analysis, RMN ablation (P < 0.001) and left atrial diameter (P = 0.013) was an independent risk factor for AF recurrence. Procedure time, radiofrequency application time and total fluoroscopy time and fluoroscopy dose were higher in the RMN group without difference in total number of ablation points. Complication rates did not differ significantly between groups (P = 0.722).

Conclusions: In our retrospective comparative study, the AF recurrence rate and pulmonary vein reconnection rate is significantly lower with more favorable procedural characteristics and similar complication rate utilizing MCN-CF compared to RMN.

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接触力传感手动导管与远程磁导航心房颤动消融术：单中心比较。

背景：远程磁导管导航（RMN）与手动导管导航结合接触力传感（MCN-CF）消融心房颤动（AF）的比较数据尚缺。本回顾性比较研究的主要目的是比较 RMN 与 MCN-CF 消融术在房颤复发方面的结果。次要目的是分析围手术期风险、消融特征和重复手术：我们回顾性分析了452名患者共605次房颤消融术：180名患者使用RMN消融，272名患者使用MCN-CF消融：除体重指数外，基线时各组间无明显差异。在平均 1.6 ± 1.6 年的随访和 1.3 ± 0.4 次手术后，MCN-CF 组有 81% 的患者不再复发房颤，而 RMN 组仅有 53% 的患者不再复发房颤（P 结论：MCN-CF 组患者的房颤复发率高于 RMN 组：在我们的回顾性比较研究中，与 RMN 相比，MCN-CF 的房颤复发率和肺静脉重接率明显较低，且具有更有利的手术特征和相似的并发症发生率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart and Vessels 医学-外周血管病

CiteScore

3.10

自引率

13.30%

发文量

211

审稿时长

2 months

期刊介绍： Heart and Vessels is an English-language journal that provides a forum of original ideas, excellent methods, and fascinating techniques on cardiovascular disease fields. All papers submitted for publication are evaluated only with regard to scientific quality and relevance to the heart and vessels. Contributions from those engaged in practical medicine, as well as from those involved in basic research, are welcomed.