Reents T, et al. – This prospective, randomized study entails a comparison between remote magnetic navigation (RMN) and manually guided catheter ablation for atrioventricular nodal reentrant tachycardia (AVNRT) regarding fluoroscopy time/dosage, acute and long–term efficacy as well as safety. RMN versus a manual approach attenuated fluoroscopy time and dosage of about 50% for both patients and physicians. Acute and midterm success and safety were comparable. Overall, RMN is a good alternative to a manual approach for AVNRT ablation.

Methods

• Researchers randomized a total of 218 patients with AVNRT undergoing catheter ablation at three centers (male 34%, mean age 50 ± 17 years), to a manual approach (n = 113) or RMN (n = 105) using the Niobe magnetic navigation system.
• The primary study endpoint was total fluoroscopy time/dosage for patient and operator at the end of the procedure.
• Acute success, procedure duration, complications and success rate after 6 months were secondary endpoints.

Results

• Findings demonstrated that fluoroscopy time and dosage for the patient were significantly reduced in the RMN group compared to the manual group (6 ± 6 vs. 11 ± 10 min;p < 0.001 and 425 ± 558 vs. 751 ± 900 cGycm², p = 0.002).
• Data reported that a reduction in fluoroscopy time/dose also applied to the operator (3 ± 5 vs. 7 ± 9 min 209 ± 444 vs. 482 ± 689 cGycm², p < 0.001).
• Researchers observed that procedure duration was significantly longer in the RMN group (88 ± 29 vs. 79 ± 29 min; p = 0.03) and crossover from the RMN group to manual ablation occurred in 7.6% of patients (7.6 vs. 0.1%; p = 0.02).
• They also noted that acute success was achieved in 100% of patients in both groups.
• In addition, data highlighted that midterm success after 6 months was 97 vs. 98% (p = 0.67).
• Researchers observed no complications in both groups.