Journal of Internal Medicine Concepts & Practice >
The learning curve of remote magnetic navigation-guided ablation for idiopathic ventricular arrhythmias
Received date: 2020-03-04
Online published: 2022-07-26
Objectives To determine the learning curve of remote magnetic navigation (RMN)-guided ablation for idiopathic ventricular arrhythmias (IVA) and its implications on the outcomes of the procedures. Methods A total of 249 IVA patients undergoing catheter ablation with RMN were divided into two groups: right ventricle (RV) and left ventricle (LV) group regarding to the initially mapping from RV or LV. Procedural outcomes and complications were compared between two groups. The learning curve was determined by plotting procedure time of the consequentially performed procedures in RV group patients. These patients were then divided equally into 3 phases (P1, P2, P3) to determine the effect of learning curve on procedure outcomes. Results The acute success rate reached 91% and complication rate was only 0.4%. The procedure time, mapping time, ablation time and X-ray time of LV group was significantly higher than RV group (P<0.05), but no significant difference was detected in the complication rate of the two groups(P=0.313 3). The procedure time of RV group patients decreased significantly along the learning curve. Compared with P2 and P1, the procedure time of P3 was decreased by 24% (P<0.01) and 41% (P<0.000 1) respectively. The X-ray time was relatively low [(3.8±4.1) min] at the very beginning and dropped significantly along the learning curve [(1.3±1.0) min, P<0.001]. Conclusions It takes rather short term to establish the learning curve of RMN-guided IVA with low rate of complication. The radiation exposure for both patient and operator is low during the establishment of learning curve and could be further reduced later on.
LI Xiang, JIN Qi, PAN Wenqi, JIA Kangni, ZHANG Ning, LIN Changjian, LING Tianyou, CHEN Kang, XIE Yucai, WU Liqun . The learning curve of remote magnetic navigation-guided ablation for idiopathic ventricular arrhythmias[J]. Journal of Internal Medicine Concepts & Practice, 2021 , 16(03) : 167 -171 . DOI: 10.16138/j.1673-6087.2021.03.006
[1] | Shivkumar K. Catheter ablation of ventricular arrhythmias[J]. N Engl J Med, 2019, 380(16): 1555-1564. |
[2] | Dinov B, Fiedler L, Schönbauer R, et al. Outcomes in catheter ablation of ventricular tachycardia in dilated nonischemic cardiomyopathy compared with ischemic cardiomyopathy: results from the Prospective Heart Centre of Leipzig VT (HELP-VT) Study[J]. Circulation, 2014, 129(7): 728-736. |
[3] | Sapp JL, Wells GA, Parkash R, et al. Ventricular tachycardia ablation versus escalation of antiarrhythmic drugs[J]. N Engl J Med, 2016, 375(2): 111-121. |
[4] | Aryana A, D’avila A, Heist EK, et al. Remote magnetic navigation to guide endocardial and epicardial catheter mapping of scar-related ventricular tachycardia[J]. Circulation, 2007, 115(10): 1191-1200. |
[5] | Virk SA, Kumar S. Remote magnetic versus manual catheter navigation for atrial fibrillation ablation: a meta-analysis[J]. Circ Arrhythm Electrophysiol, 2019, 12(10): e007517. |
[6] | Xie Y, Jin Q, Zhang N, et al. Strategy of catheter ablation for para-Hisian premature ventricular contractions with the assistance of remote magnetic navigation[J]. J Cardiovasc Electrophysiol, 2019, 30(12): 2929-2935. |
[7] | Qian P, De Silva K, Kumar S, et al. Early and long-term outcomes after manual and remote magnetic navigation-guided catheter ablation for ventricular tachycardia[J]. Europace, 2018, 20 Suppl 2: ii11-ii21. |
[8] | Aagaard P, Natale A, Briceno D, et al. Remote magnetic navigation: a focus on catheter ablation of ventricular arrhythmias[J]. J Cardiovasc Electrophysiol, 2016, 27(S1): S38-S44. |
[9] | Qiu X, Zhang N, Luo Q, et al. Remote magnetic navigation facilitates the ablations of frequent ventricular premature complexes originating from the outflow tract and the valve annulus as compared to manual control navigation[J]. Int J Cardiol, 2018, 267: 94-99. |
[10] | Shauer A, De Vries LJ, Akca F, et al. Clinical research: remote magnetic navigation vs. manually controlled catheter ablation of right ventricular outflow tract arrhythmias: a retrospective study[J]. Europace, 2018, 20 Suppl 2: ii28-ii32. |
[11] | Davis DR, Tang AS, Gollob MH, et al. Remote magnetic navigation-assisted catheter ablation enhances catheter stability and ablation success with lower catheter temperatures[J]. Pacing Clin Electrophysiol, 2008, 31(7): 893-898. |
[12] | Xie Y, Jin Q, Zhang N, et al. Strategy of catheter ablation for para-Hisian premature ventricular contractions with the assistance of remote magnetic navigation[J]. J Cardiovasc Electrophysiol, 2019, 30(12): 2929-2935. |
[13] | Hosseini SM, Rozen G, Saleh A, et al. Catheter ablation for cardiac arrhythmias: utilization and in-hospital complications, 2000 to 2013[J]. JACC Clin Electrophysiol, 2017, 3(11): 1240-1248. |
[14] | Turagam MK, Atkins D, Tung R, et al. A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation[J]. J Interv Card Electrophysiol, 2017, 49(3): 227-235. |
/
〈 |
|
〉 |