Catheter Ablation of Focal Atrial Tachycardia Using Remote Magnetic Navigation

Objectives. The outcomes of catheter ablation in focal atrial tachycardia (AT) using remote magnetic navigation (RMN) are still controversial. The objectives of this study were to assess the acute and long-term outcomes of catheter ablation in focal AT using RMN. Background. A total of 53 patients with focal AT who underwent catheter ablation using RMN were included. Thirty-six patients had structural heart disease, including previous atrial fibrillation ablation and heart surgery (abnormal group), and the remaining 17 patients had no structural heart disease (normal group). Methods. In 53 patients, a total of 56 atrial foci were found. Acute success of the primary ablation was obtained in 52 patients (98%). Mean procedure duration was 109 +/- 35 min, ablation duration was 401 sec (interquartile range [IQR], 332 sec), and fluoroscopy time was 5.0 min [IQR, 3.0 min]. After a mean follow-up of 31 +/- 18 months, 47 patients (89%) were free from focal AT. No major complications were observed. In the abnormal group, age and target atrium volume were higher and the left ventricular ejection fraction was lower when compared to the normal group. However, there were no significant differences in procedure duration (normal group 106 +/- 31 min vs abnormal group 111 +/- 37 min); ablation duration (normal group 457 sec [IQR, 412 sec] vs abnormal group 378 sec [IQR, 217 sec]); fluoroscopy time (normal group 4.2 min [IQR, 3.0 min] vs abnormal group 5.4 min [IQR, 3.3 min]); acute success rate (normal group 100% vs abnormal group 97%); and long-term success rate (normal group 88% vs abnormal group 89%) between the two groups (P>.05). Conclusion. Our study has demonstrated that catheter ablation of focal AT using RMN is safe and effective, with low fluoroscopy exposure.