Abstract 15656: Manual vs Remote Magnetic Navigation for Ventricular Tachycardia Ablation: A Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ghulam Murtaza ◽  
Mohit K Turagam ◽  
Jalaj Garg ◽  
Krishna Akella ◽  
Donita Atkins ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Final Analysis ◽  
Magnetic Navigation ◽  
Continuous Variables ◽  
Remote Magnetic Navigation ◽  
Ventricular Tachycardia Ablation ◽  
Vt Ablation ◽  
Mean Differences

Introduction: The role of remote magnetic navigation (RMN) for ventricular tachycardia (VT) ablation is not well established. In this meta- analysis, we aim to evaluate the safety and efficacy of RMN vs manual navigation (MAN) for VT ablation. Methods: A comprehensive literature search in PubMed, Google Scholar and Cochrane Review from inception till November 9th, 2019 was performed. Studies reporting clinical outcomes comparing MAN vs RMN were included. Two investigators independently extracted the data and individual quality assessment was performed. Results were expressed as odds ratio (OR) for dichotomous outcomes and mean differences (MD) for continuous variables with 95% confidence intervals (CI). Results: Eight studies including a total of 861 patients (475 in RMN arm and 386 in MAN arm) were included in the final analysis. VT recurrence was significantly lower with RMN compared with MAN (OR 0.65, 95% CI 0.48-0.88, p= 0.005). Acute procedural success was significantly higher with RMN (OR 2.21, 95% CI 1.51-3.23, p < 0.0001). Total procedure time [MD -8.83, 95% CI -17.72- 0.05, p=0.05], fluoroscopy time [MD -10.24, 95% CI -12.28- -8.19, p= 0.00001), and complications [OR 0.36, 95% CI 0.18- 0.72, p= 0.003] were significantly lower in RMN compared to MAN. Conclusion: Results of our meta-analysis indicate that RMN is safer and more effective than MAN in patients with VT undergoing ablation. Further, randomized studies are needed to validate these findings.

A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation

2017 ◽  
Vol 49 (3) ◽  
pp. 227-235 ◽  
Author(s):  
Mohit K. Turagam ◽  
Donita Atkins ◽  
Roderick Tung ◽  
Moussa Mansour ◽  
Jeremy Ruskin ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation ◽  
Ventricular Tachycardia Ablation

scholarly journals Remote magnetic navigation vs. manual navigation for ablation of ventricular tachycardia: a meta-analysis

2015 ◽  
Vol 23 (10) ◽  
pp. 485-490 ◽  
Author(s):  
Y. Wu ◽  
K.-L. Li ◽  
J. Zheng ◽  
C.-Y. Zhang ◽  
X.-Y. Liu ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation

scholarly journals Pre-procedural image-guided versus non-image-guided ventricular tachycardia ablation—a review

2020 ◽  
Vol 28 (11) ◽  
pp. 573-583 ◽  
Author(s):  
A. A. Hendriks ◽  
Z. Kis ◽  
M. Glisic ◽  
W. M. Bramer ◽  
T. Szili-Torok
Keyword(s):  
Overall Survival ◽  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Bibliographic Databases ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ventricular Tachycardia Ablation ◽  
Image Guided ◽  
Vt Ablation

Abstract Background Magnetic resonance imaging and computed tomography in patients with ventricular tachycardia (VT) after myocardial infarction (MI) helps to delineate scar from healthy tissue. Image-guided VT ablation has not yet been studied on a large scale. Objective The aim of the meta-analysis was to compare the long-term outcome of image-guided VT ablation with a conventional approach for VT after MI. Methods Eight electronic bibliographic databases were searched to identify all relevant studies from 2012 until 2018. The search for scientific literature was performed for studies that described the outcome of VT ablation in patients with an ischaemic substrate. The outcome of image-guided ablation was compared with the outcome of conventional ablations. Results Of the 2990 citations reviewed for eligibility, 38 articles—enrolling a total of 7748 patients—were included into the meta-analysis. Five articles included patients with image-guided ablation. VT-free survival was 82% [74–90] in the image-guided VT ablation versus 59% [54–64] in the conventional ablation group (p < 0.001) during a mean follow-up of 35 months. Overall survival was 94% [90–98] in the image-guided versus 82% [76–88] in the conventional VT ablation group (p < 0.001). Conclusions Image-guided VT ablation in ischaemic VT was associated with a significant benefit in VT-free and overall survival as compared with conventional VT ablation. Visualising myocardial scar facilitates substrate-guided ablation procedures, pre-procedurally and by integrating imaging during the procedure, and may consequently improve long-term outcome.

scholarly journals Contact feedback improves 1-year outcomes of remote magnetic navigation-guided ischemic ventricular tachycardia ablation

2020 ◽  
Vol 315 ◽  
pp. 36-44
Author(s):  
Anna Maria Elisabeth Noten ◽  
Astrid Armanda Hendriks ◽  
Sing-Chien Yap ◽  
Daniel Mol ◽  
Rohit Bhagwandien ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation ◽  
Ventricular Tachycardia Ablation

Ventricular scar channel entrances identified by new wideband cardiac magnetic resonance sequence to guide ventricular tachycardia ablation in patients with cardiac defibrillators

EP Europace ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 598-606
Author(s):  
Ivo Roca-Luque ◽  
Ana Van Breukelen ◽  
Francisco Alarcon ◽  
Paz Garre ◽  
Jose M Tolosana ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Standard Procedure ◽  
False Negative ◽  
False Negative Rate ◽  
Historical Cohort ◽  
Ventricular Tachycardia Ablation ◽  
Vt Ablation ◽  
Lge Cmr

Abstract Aims Ventricular tachycardia (VT) substrate-based ablation has become a standard procedure. Electroanatomical mapping (EAM) detects scar tissue heterogeneity and define conduction channels (CCs) that are the ablation target. Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) is able to depict CCs and increase ablation success. Most patients undergoing VT ablation have an implantable cardioverter-defibrillator (ICD) that can cause image artefacts in LGE-CMR. Recently wideband (WB) LGE-CMR sequence has demonstrated to decrease these artefacts. The aim of this study is to analyse accuracy of WB-LGE-CMR in identifying the CC entrances. Methods and results Thirteen consecutive ICD-patients who underwent VT ablation after WB-LGE-CMR were included. Number and location of CC entrances in three-dimensional EAM and in WB-LGE-CMR reconstruction were compared. Concordance was compared with a historical cohort matched by cardiomyopathy, scar location, and age (26 patients) with LGE-CMR prior to ICD and VT ablation. In WB-CMR group, 101 and 93 CC entrances were identified in EAM and WB-LGE-CMR, respectively. In historical cohort, 179 CC entrances were identified in both EAM and LGE-CMR. The EAM/CMR concordance was 85.1% and 92.2% in the WB and historical group, respectively (P = 0.66). There were no differences in false-positive rate (CC entrances detected in CMR and absent in EAM: 7.5% vs 7.8% in WB vs. conventional CMR, P = 0.92) nor in false-negative rate (CC entrances present in EAM not detected in CMR: 14.9% vs.7.8% in WB vs. conventional CMR, P = 0.23). Epicardial CCs was predictor of poor CMR/EAM concordance (OR 2.15, P = 0.031). Conclusion Use of WB-LGE-CMR sequence in ICD-patients allows adequate VT substrate characterization to guide VT ablation with similar accuracy than conventional LGE-CMR in patients without an ICD.

Remote Magnetic Navigation to Map and Ablate Left Coronary Cusp Ventricular Tachycardia

2006 ◽  
Vol 17 (10) ◽  
pp. 1142-1144 ◽  
Author(s):  
J. DAVID BURKHARDT ◽  
WALID I. SALIBA ◽  
ROBERT A. SCHWEIKERT ◽  
JENNIFER CUMMINGS ◽  
ANDREA NATALE
Keyword(s):  
Ventricular Tachycardia ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation ◽  
Coronary Cusp

scholarly journals Preventive Ventricular Tachycardia Ablation in Patients with Ischaemic Cardiomyopathy: Meta-analysis of Randomised Trials

2019 ◽  
Vol 8 (3) ◽  
pp. 173-179 ◽  
Author(s):  
Roland R Tilz ◽  
Charlotte Eitel ◽  
Evgeny Lyan ◽  
Kivanc Yalin ◽  
Spyridon Liosis ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Catheter Ablation ◽  
Secondary Prevention ◽  
Meta Analysis ◽  
Randomised Trials ◽  
Icd Implantation ◽  
Icd Therapy ◽  
Number Of Patients ◽  
Significant Difference ◽  
Vt Ablation

Catheter ablation of ventricular tachycardia (VT) aims to treat the underlying arrhythmia substrate to prevent ICD therapies. The aim of this meta-analysis was to assess the safety and efficacy of VT ablation prior to or at the time of secondary prevention ICD implantation in patients with coronary artery disease, as compared with deferred VT ablation. Based on a systematic literature search, three randomised trials were considered eligible for inclusion in this analysis, and data on the number of patients with appropriate ICD shocks, appropriate ICD therapy, arrhythmic storm, death and major complications were extracted from each study. On pooled analysis, there was a significant reduction of appropriate ICD shocks (OR 2.58; 95% CI [1.54–4.34]; p<0.001) and appropriate ICD therapies (OR 2.04; 95% CI [1.15–3.61]; p=0.015) in patients undergoing VT ablation at the time of ICD implantation without significant differences with respect to complications (OR 1.39; 95% CI [0.43–4.51]; p=0.581). Mortality did not differ between both groups (OR 1.30; 95% CI [0.60–2.45]; p=0.422). Preventive catheter ablation of VT in patients with coronary heart disease at the time of secondary prevention ICD implantation results in a significant reduction of appropriate ICD shocks and any appropriate ICD therapy compared with patients without or with deferred VT ablation. No significant difference with respect to complications or mortality was observed between both treatment strategies.

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