Author + information
- Georg Noelker,
- Bogdan Muntean,
- Johannes Heintze,
- Juergen Vogt,
- Dieter Horstkotte and
- Klaus-Jürgen Gutleben
Magnetically guided atrial fibrillation (AF) ablation (MGAFA) has been introduced as a valuable alternative technique. Intracardiac echo (ICE) is the last remaining manually directed tool in MGAFA.
The ICE catheter fixed by two handle clamps (AcuNav, Biosense Webster, Fig 1A) was directed remotely from a vena cava superior position applying V-SONO technology (Stereotaxis) allowing for posterior/anterior deflection, advancing/retraction, clock and counterclockwise rotation to guide transseptal access to the left atrium (LA) (tableside-controlled, Fig 1 B), validate positioning of the also remotely directed Lasso (V-LOOP, Stereotaxis), exclude pericardial effusion (PE) during the procedure and rule out pulmonary vein stenosis (PVS) (remote user interface situated in the control room, Fig 1 C).
Six consecutive patients (5 males, 56.8 ± 19.6 years) suffering from persistent AF (4), left atrial tachycardia (1) or both (1) were included. A total of 19±7 remotely directed moves of the ICE were made to guide transseptal puncture (3±1), direct the Lasso in the LA (14±6) and rule out PE and PVS (2±4). Procedure and fluoroscopy times were 268±59 and 11±6 minutes, respectively. No manual moves were required in any of the procedures. There were no intraprocedural complications.
From our early experience remotely directable ICE seems to be a valuable complimentary tool in MGAFA fully superseding manual interaction.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias: AF/SVT V
Abstract Category: 4. Arrhythmias: AF/SVT
Presentation Number: 1189-31
- 2013 American College of Cardiology Foundation