A Comparison of Remote Magnetic Irrigated Tip Ablation versus Manual Catheter Irrigated Tip Catheter Ablation With and Without Force Sensing Feedback

Abstract

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).Conclusion: 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

Radiofrequency catheter ablation of atrial fibrillation: Electrical modification suggesting transmurality is faster achieved with remote magnetic catheter in comparison with contact force use

“…A similar distribution of EGM morphologies between the two groups was found before RF applications, suggesting a similar orientation of the catheters on the tissue with both technologies . Our results are in line with a recent comparative study between RMN and CF‐guided AF ablation . Natale et al .…”

“…18 Our results are in line with a recent comparative study between RMN and CF-guided AF ablation. 19…”

Robotics for catheter ablation of cardiac arrhythmias: Current technologies and practical approaches

“…Several retrospective and prospective cohort studies have shown that RMN‐guided ablation of AF was associated with low complication rates and comparable long‐term freedom from AF when compared to manual ablation 22–24,26 21 …”

Remote magnetic navigation for ventricular ablation: did the machine win this round?

“…Despite numerous publications showing reductions in fluoroscopic exposure and the obvious benefits of not wearing lead and standing tableside for hours, remote magnetic navigation has not become the standard of care in the world [4]. Most publications appear to show similar success rates, and many show favorable complication rates [5][6][7]. So what is the limitation to universal acceptance?…”

“…This limitation also makes manual catheter contact force in certain areas inconsistent or suboptimal, which may also result in insufficient ablation lesions. Maps obtained via magnetic navigation tend to have less distortion and more accurately represent the chamber of interest [5,8]. The more uniform and constant contact may also improve the ablation lesions.…”