This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Faddis, M. N. Articles by Lindsay, B. D. Search for Related Content PubMed PubMed Citation Articles by Faddis, M. N. Articles by Lindsay, B. D.

CLINICAL RESEARCH: CARDIAC ELECTROPHYSIOLOGY

Magnetic guidance system for cardiac electrophysiology

a prospective trial of safety and efficacy in humans

^* Washington University School of Medicine, St. Louis, Missouri, USA

Manuscript received February 17, 2003; revised manuscript received July 9, 2003, accepted July 14, 2003.

^* Reprint requests and correspondence: Dr. Mitchell N. Faddis, Cardiology—Box 8086, 660 S. Euclid Avenue, St. Louis, Missouri 63110, USA.
MitchNF{at}pol.net

OBJECTIVES: We evaluated in humans the safety and efficacy of a novel magnetic guidance system (MGS) for electrophysiological mapping, pacing, and ablation.

BACKGROUND: Catheter ablation of atrial fibrillation and other complex arrhythmias requires precise catheter manipulation and stabilization. We have shown in animals that the MGS can precisely manipulate a mapping catheter within the heart with an external magnetic field rather than manual catheter control.

METHODS: Thirty-one adults referred for diagnostic electrophysiology studies were enrolled in a prospective trial of the MGS. The magnetic catheter was navigated to preselected sites in the right atrium (RA) and right ventricle (RV) in the first 20 patients. Electrograms were recorded at each target site, and pacing thresholds were measured. In a subset of five patients, RA and RV electrograms and stimulation thresholds were recorded with both a standard ablation catheter and the magnetic catheter. Eleven additional patients were recruited for supraventricular tachycardia (SVT) mapping, and seven of these underwent ablation.

RESULTS: Navigation was successful in 200 of 202 predetermined right-sided navigation targets and 13 of 13 targets in the left atria. Pacing thresholds and electrogram amplitudes in the RA and RV were not significantly different between the standard and magnetic catheters. The SVT mapping with the magnetic catheter was successful in 13 patients, including 4 with left-sided accessory pathways. The MGS was used for successful ablation of SVT in seven of seven patients. There were no procedural complications.

CONCLUSIONS: These results demonstrate that the MGS can be used for intracardiac mapping, pacing, and ablation safely and effectively.

Abbreviations and Acronyms   AV = atrioventricular   ECG = electrocardiogram   LAO = left anterior oblique   MGS = magnetic guidance system   RA = right atrium   RAO = right anterior oblique   RV = right ventricle/ventricular   SVT = supraventricular tachycardia

This article has been cited by other articles:

				B. Schmidt, K. R. J. Chun, R. R. Tilz, B. Koektuerk, F. Ouyang, and K.-H. Kuck Remote navigation systems in electrophysiology Europace, November 1, 2008; 10(suppl_3): iii57 - iii61. [Abstract] [Full Text] [PDF]

				W. Saliba, V. Y. Reddy, O. Wazni, J. E. Cummings, J. D. Burkhardt, M. Haissaguerre, J. Kautzner, P. Peichl, P. Neuzil, V. Schibgilla, et al. Atrial fibrillation ablation using a robotic catheter remote control system initial human experience and long-term follow-up results. J. Am. Coll. Cardiol., June 24, 2008; 51(25): 2407 - 2411. [Abstract] [Full Text] [PDF]

				R. Mehta, D. T. Hart, B. S. Nagra, Z. Liu, and B. K. Kantharia Successful ablation of focal left atrial tachycardia using Stereotaxis NiobeTM remote magnetic navigation system Europace, March 1, 2008; 10(3): 280 - 283. [Abstract] [Full Text] [PDF]

				B. D. Lindsay Is Pulmonary Vein Antrum Isolation a Critical Determinant of Recurrent Arrhythmias After Ablation of Atrial Fibrillation? J. Am. Coll. Cardiol., August 28, 2007; 50(9): 875 - 876. [Full Text] [PDF]

				V. Y. Reddy, P. Neuzil, Z. J. Malchano, R. Vijaykumar, R. Cury, S. Abbara, J. Weichet, C. D. McPherson, and J. N. Ruskin View-Synchronized Robotic Image-Guided Therapy for Atrial Fibrillation Ablation: Experimental Validation and Clinical Feasibility Circulation, May 29, 2007; 115(21): 2705 - 2714. [Abstract] [Full Text] [PDF]

				A. Aryana, A. d'Avila, E. K. Heist, T. Mela, J. P. Singh, J. N. Ruskin, and V. Y. Reddy Remote Magnetic Navigation to Guide Endocardial and Epicardial Catheter Mapping of Scar-Related Ventricular Tachycardia Circulation, March 13, 2007; 115(10): 1191 - 1200. [Abstract] [Full Text] [PDF]

				J. K.-R. Chun, S. Ernst, S. Matthews, B. Schmidt, D. Bansch, S. Boczor, A. Ujeyl, M. Antz, F. Ouyang, and K.-H. Kuck Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory Eur. Heart J., January 11, 2007; (2007) ehl447v1. [Abstract] [Full Text] [PDF]

				C. Pappone, G. Vicedomini, F. Manguso, F. Gugliotta, P. Mazzone, S. Gulletta, N. Sora, S. Sala, A. Marzi, G. Augello, et al. Robotic Magnetic Navigation for Atrial Fibrillation Ablation J. Am. Coll. Cardiol., April 4, 2006; 47(7): 1390 - 1400. [Abstract] [Full Text] [PDF]

				A.S. Thornton, P. Janse, D.A.M.J. Theuns, M.F. Scholten, and L.J. Jordaens Magnetic navigation in AV nodal re-entrant tachycardia study: early results of ablation with one- and three-magnet catheters. Europace, April 1, 2006; 8(4): 225 - 230. [Abstract] [Full Text] [PDF]

				B. D. Lindsay Perspectives on the development of a magnetic navigation system for remote control of electrophysiology catheters. Europace, April 1, 2006; 8(4): 231 - 232. [Full Text] [PDF]

				S. R. Atmakuri, E. I. Lev, C. Alviar, E. Ibarra, A. E. Raizner, S. L. Solomon, and N. S. Kleiman Initial Experience With a Magnetic Navigation System for Percutaneous Coronary Intervention in Complex Coronary Artery Lesions J. Am. Coll. Cardiol., February 7, 2006; 47(3): 515 - 521. [Abstract] [Full Text] [PDF]

				D. L. Miller Why Use Remote Guidance to Steer Catheters and Guide Wires? Radiology, August 1, 2004; 232(2): 313 - 314. [Full Text] [PDF]

				W. W. O'Neill and S. R. Dixon The year in interventional cardiology J. Am. Coll. Cardiol., March 3, 2004; 43(5): 875 - 890. [Full Text] [PDF]