Author + information
- Guillaume Bassil,
- Layth Saleh,
- Steven Markowitz,
- Christopher Liu,
- George Thomas,
- James Ip,
- Bruce Lerman and
- Jim Cheung
Introduction: The utility of remote magnetic navigation (RMN)-guided ablation of ventricular arrhythmias (VAs) arising from the left ventricular (LV) summit via the coronary venous (CV) system (distal great cardiac vein [GCV], anterior interventricular vein [AIV] or GCV-AIV junction) has not been described.
Methods: We evaluated 24 consecutive pts (mean age 58 ± 16 years, 46% female) who underwent catheter ablation of LV summit VAs (n = 20 for PVCs and n =4 for VT) via the CV system. Catheter ablation was initially performed using RMN approach in 13 (54%) pts and manual approach in 11 (46%) pts. Demographic and procedural data were recorded and compared between the two groups.
Results: Acute procedural success was obtained in 9 (69%) RMN pts and 6 (55%) manual pts (p = 0.14). The VA sites of origin were mapped to the distal GCV in 3 pts (12%), the GCV-AIV junction in 16 pts [67%], and AIV in 5 pts [21%]. Of 13 RMN patients, conversion to manual ablation was required in 2 (15%) pts. Complications were seen in 0 (0%) RMN pts and 2 (18%) manual ablation pts (both with pericardial effusions) (p = 0.20). No pts sustained coronary injury following ablation in the distal CV region.
Conclusions: RMN-guided catheter ablation of LV summit VAs via the CV system appears to be at least as safe and effective as manual-guided ablation, and may be able to navigate in manually inaccessible areas. Larger studies are needed to assess whether potential advantages of an RMN ablation approach are confirmed in this technically challenging anatomic space.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Innovative Approaches for Reducing Risk and Improving Outcomes With Ablation
Abstract Category: 8. Arrhythmias and Clinical EP: Supraventricular/Ventricular Arrhythmias
Presentation Number: 1237-102
- 2017 American College of Cardiology Foundation