TY - JOUR
T1 - Remote vs. conventional navigation for catheter ablation of atrial fibrillation: insights from prospective registry data
AU - van den Bruck, Jan Hendrik
AU - Sultan, Arian
AU - Lüker, Jakob
AU - Thomas, Dierk
AU - Willems, Stephan
AU - Weinmann, Kai
AU - Kuniss, Malte
AU - Hochadel, Matthias
AU - Senges, Jochen
AU - Andresen, Dietrich
AU - Brachmann, Johannes
AU - Kuck, Karl Heinz
AU - Tilz, Roland
AU - Steven, Daniel
N1 - Funding Information:
The Foundation Institut für Herzinfarktforschung (IHF, Ludwigshafen, Germany) as the central contract research organization for this study was responsible for project management, data management and clinical monitoring. The respective physician or study nurse in the participating center performed the data acquisition of patient characteristics, procedural data and complication monitoring. Documentation and data management was handled paperless as an internet-based case report form system; all obtained information was confidential and the transmitted data from the participating center was encrypted with a secure socket layer. The final data management, description of the biometric model and statistical analysis was carried out by the IHF [22].
Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Background: Robotic (RNS) or magnetic navigation systems (MNS) are available for remotely performed catheter ablation for atrial fibrillation (AF). Objective: The present study compares remotely assisted catheter navigation (RAN) to standard manual navigation (SMN) and both systems amongst each other. Methods: The analysis is based on a sub-cohort enrolled by five hospitals from the multicenter German ablation Registry. Results: Out of 2442 patients receiving catheter ablation of AF, 267 (age 61.4 ± 10.4, 69.7% male) were treated using RAN (RNS n = 187, 7.7% vs. MNS n = 80, 3.3%). Fluoroscopy time [RNS median 17 (IQR 12–25) min vs. MNS 22 (16–32) min; p < 0.001] and procedure duration [RNS 180 (145–220) min vs. MNS 265 (210–305) min; p < 0.001] were significantly different. Comparing RAN (11%) to SMN (89%) fluoroscopy time (RAN 19 (13–27) min, vs. SMN 25 (16–40) min; p < 0.001), energy delivery (RAN 3168 (2280–3840) s vs. SMN 2640 (IQR 1799–3900) s; p = 0.008) and procedure duration [RAN 195 (150–255) min vs. SMN 150 (120–150) min; p = 0.001] differed significantly. In terms of acute and 12 months outcome, no differences were seen between the two systems or in comparison to SMN. Conclusion: AF ablation can be performed safely, with high acute success rates using RAN. RNS results in less fluoroscopy burden and shorter procedure durations. Compared to SMN, a reduced fluoroscopy burden, prolonged procedure and ablation duration were observed using RAN. Overall, the number of RAN procedures is small suggesting low impact on clinical routine of AF ablation.
AB - Background: Robotic (RNS) or magnetic navigation systems (MNS) are available for remotely performed catheter ablation for atrial fibrillation (AF). Objective: The present study compares remotely assisted catheter navigation (RAN) to standard manual navigation (SMN) and both systems amongst each other. Methods: The analysis is based on a sub-cohort enrolled by five hospitals from the multicenter German ablation Registry. Results: Out of 2442 patients receiving catheter ablation of AF, 267 (age 61.4 ± 10.4, 69.7% male) were treated using RAN (RNS n = 187, 7.7% vs. MNS n = 80, 3.3%). Fluoroscopy time [RNS median 17 (IQR 12–25) min vs. MNS 22 (16–32) min; p < 0.001] and procedure duration [RNS 180 (145–220) min vs. MNS 265 (210–305) min; p < 0.001] were significantly different. Comparing RAN (11%) to SMN (89%) fluoroscopy time (RAN 19 (13–27) min, vs. SMN 25 (16–40) min; p < 0.001), energy delivery (RAN 3168 (2280–3840) s vs. SMN 2640 (IQR 1799–3900) s; p = 0.008) and procedure duration [RAN 195 (150–255) min vs. SMN 150 (120–150) min; p = 0.001] differed significantly. In terms of acute and 12 months outcome, no differences were seen between the two systems or in comparison to SMN. Conclusion: AF ablation can be performed safely, with high acute success rates using RAN. RNS results in less fluoroscopy burden and shorter procedure durations. Compared to SMN, a reduced fluoroscopy burden, prolonged procedure and ablation duration were observed using RAN. Overall, the number of RAN procedures is small suggesting low impact on clinical routine of AF ablation.
UR - http://www.scopus.com/inward/record.url?scp=85052671996&partnerID=8YFLogxK
U2 - 10.1007/s00392-018-1356-6
DO - 10.1007/s00392-018-1356-6
M3 - Journal articles
C2 - 30159751
AN - SCOPUS:85052671996
SN - 1861-0684
VL - 108
SP - 298
EP - 308
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
IS - 3
ER -
