Catheter Ablation of Ischemic Ventricular Tachycardia With Remote Magnetic Navigation: STOP‐VT Multicenter Trial

Abstract

Conclusions: This first prospective, single-procedure, multicenter study indicates that remote magnetic navigation is a safe and effective method for catheter ablation of post

Substrate characterization and catheter ablation in patients with scar‐related ventricular tachycardia using ultra high‐density 3‐D mapping

“…Our experience regarding the feasibility of ventricular mapping using the novel basket catheter and related underlying annotation algorithms is in line with the recently published first case series on this new mapping catheter and system . The acquired mapping points in the present study exceed the usual amount gained by established 3‐D mapping systems by far and information on the underlying morphological and functional substrate could be obtained simultaneously. Compared to our experience, mapping time during sinus or paced rhythm is not faster than established 3‐D mapping systems despite using the multielectrode basket catheter, but, importantly, results in high spatial resolution of voltage maps and reliable isochronal maps with minimized inaccuracies from interpolation.…”

“…The induced VT was defined as the clinical VT, when cycle length (CL, within 20 miliseconds) and morphology matched previous recordings (12-lead ECG and/or device recordings). If a 12-lead ECG of the presenting VT was not available before ablation, induced VT similar in rate and intracardiac electrogram pattern to a spontaneous VT detected by an ICD were designated presumptive clinical VT. 2,11,12 Hemodynamic instability was defined as mean arterial blood pressure below 50 mmHg (invasive measurement). A catheter in the coronary sinus (CS) served as the reference for the Rhythmia TM 3-D electro-anatomical mapping system (Boston Scientific) in most cases.…”

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

“…Studies examining outcomes using RMN for catheter ablation of ventricular arrhythmias (VAs) are summarized in Table 2. Several retrospective and prospective observational studies of ablation of scar‐associated ventricular tachycardia (VT) have shown that RMN‐guided ablation is associated with lower fluoroscopy times, comparable procedure times and comparable success rates when compared to manual ablation 27,29,30 …”

“…21 guided ablation is associated with lower fluoroscopy times, comparable procedure times and comparable success rates when compared to manual ablation. 27,29,30 However, all of these studies are limited by its observational design, which introduces selection bias into the analyses. The ongoing prospective randomized controlled MAG-NETIC VT trigal is enrolling subjects with ischemic VT and severe left ventricular dysfunction and randomizing them to treatment with RMN-guided versus manual ablation with the primary study endpoint being 1-year freedom from VT. 35 Several retrospective observational studies have identified either improved or comparable success rates for ablation of idiopathic ventricular arrhythmias (VAs) using RMN-guided ablation when compared to manual ablation.…”

Robotic magnetic navigation for ablation of human arrhythmias

“… 35 Prospective data on treatment using the robotic technique are beginning to be validated in the treatment of ventricular tachycardia. 38 – 40 A recent study has compared the manual (n=80) and robotic methods and has shown the robotic method to be superior in the treatment of ischemic ventricular tachycardia over a follow-up period of 15 months, with a recurrence rate of 41% versus 19%, respectively. 37 While the results appear to be similar in other indications, such as dilated cardiomyopathy or dysplasia, the utility of RMNS in the epicardial approach is widely reported in the international literature.…”