Radiofrequency atrial fibrillation ablation with irrigated tip catheter using remote magnetic navigation compared with c
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Radiofrequency atrial fibrillation ablation with irrigated tip catheter using remote magnetic navigation compared with conventional manual method Rugheed Ghadban 1 & Kristina Gifft 2 & Zachary Luebbering 3 & Sandeep Sodhi 1 & Daniel Cooper 1 & Tariq Enezate 4 Received: 22 June 2020 / Accepted: 14 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Studies comparing manual catheter navigation (MCN) to remote magnetic navigation (RMN) for atrial fibrillation (AF) ablation showed variable results. Objective The aim of this meta-analysis is to compare the safety and clinical outcomes of AF radiofrequency (RF) ablation using MCN versus RMN with irrigated tip catheters. Methods Medline and the Cochrane Central Register of Controlled Trials (CENTRAL) were queried from inception through January 2019. Studies comparing safety and clinical outcomes of AF ablation with RF using MCN versus RMN with irrigated tip catheters were included. Random effects meta-analysis was used to pool outcomes across studies. Study endpoints included freedom of AF at the end of the study, procedure total time, fluoroscopy time, and complications. Results A total of 14 studies (3 controlled non-randomized trials, 1 prospective observational, and 10 retrospective observational studies) involving 3375 patients (1871 in MCN and 1504 in RMN) were included in this meta-analysis. There was no significant difference between the two groups in terms of freedom of AF (OR 1.08, 95% CI 0.82–1.42, p = 0.52). The MCN group was associated with shorter procedure time (mean difference in minutes − 50.39, 95% CI − 67.99 to − 32.79, p < 0.01), longer fluoroscopy time (mean difference in minutes 18.01, 95% CI 10.73–25.29, p < 0.01), and higher complication rate (OR 2.18, 95% CI 1.24–3.82, p < 0.01). Conclusions AF ablation utilizing MCN was associated with similar efficacy to RMN but with higher complication rates. Although the procedure time was shorter with MCN, the fluoroscopy time was more prolonged. Randomized clinical studies are needed to further verify these results. Keywords Atrial fibrillation . Ablation . Manual catheter navigation . Remote magnetic navigation . And outcomes
1 Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10840-020-00879-8) contains supplementary material, which is available to authorized users. * Tariq Enezate [email protected] 1
Division of Cardiology, Washington University, St Louis, MO, USA
2
Department of General Medicine, University of Missouri Health Care, Columbia, MO, USA
3
Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, MO, USA
4
Division of Cardiology, University of California Log Angeles-Harbor Medical Center, 1000 W Carson St., Torrance, CA 90502, USA
Atrial fibrillation (AF) was reported to affect up to 4% of the American population and is increasing each year due to a rapidly aging population and improvements in health awareness. [1] Its presence not only increase
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