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.

中文翻译：

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接触力感应手动导管与房颤远程磁导航消融：单中心比较

背景

缺乏比较远程磁导管导航 (RMN) 与手动导管导航结合接触力传感 (MCN-CF) 消融房颤 (AF) 的数据。本回顾性比较研究的主要目的是比较 RMN 与 (vs.) MCN-CF 消融 AF 的 AF 复发的结果。次要目的是分析围手术期风险、消融特征和重复手术。

方法

我们回顾性分析了 452 名接受 605 次 AF 消融的患者：180 名患者使用 RMN 消融，272 名患者使用 MCN-CF 消融。

结果

除体重指数外，基线时各组之间没有显着差异。经过平均 1.6 ± 1.6 年的随访和 1.3 ± 0.4 次手术后，MCN-CF 组中 81% 的患者未出现房颤复发，而 RMN 组中这一比例为 53%（P  < 0.001）。对 153 次重复消融（83 MCN-RF vs. 70 RMN；P  = 0.18）进行分析后，RMN 消融后肺静脉重新连接率显着升高（P  < 0.001）。在多变量Cox回归分析中，RMN消融（P  <0.001）和左心房直径（P  =0.013）是AF复发的独立危险因素。RMN 组的手术时间、射频应用时间、总透视时间和透视剂量较高，但消融点总数没有差异。各组之间的并发症发生率没有显着差异（P  = 0.722）。

结论

在我们的回顾性比较研究中，与 RMN 相比，使用 MCN-CF 的 AF 复发率和肺静脉重新连接率显着降低，具有更有利的手术特征和相似的并发症发生率。