Radiofrequency ablation of atrioventricular nodal reentrant tachycardia using a novel magnetic guidance system compared with a conventional approach

Background: A novel magnetic guidance system has been developed that allows the operator to remotely navigate an electrophysiology mapping/ ablation catheter to precise locations in the heart for treatment of tachyarrhythmias. To date, this new technology has not been directly compared with the conventional approach. Objective: To compare the use of the magnetic guidance system to the conventional approach for ablation of atrioventricular nodal reentry tachycardia. Methods: Between November 2002 and October 2004, 28 patients with atrioventricular nodal reentry tachycardia treated with the magnetic guidance system were retrospectively compared with 28 matched control patients. Results: Patients treated using the magnetic guidance system had similar procedure durations and fluoroscopy times compared with the matched controls. The only statistically significant difference between the groups was a longer time between insertion of the ablation catheter and placement of the first radiofrequency lesion in the magnetic guidance system cohort (23.3 ± 12.0 vs. 10.5 ± 13.9, p=0.001), possibly due to the research protocol. However, there was a trend toward a shorter total time that radiofrequency energy was applied in the magnetic guidance system cohort (5.2 ± 4.5 vs. 8.0 ± 7.2, p=0.087). There were no major complications or recurrences after at least 3 months of follow-up among the patients treated with the magnetic guidance system. Conclusion: The magnetic guidance system appears to have similar, and possibly improved, clinical efficacy compared with conventional catheter navigation for the treatment of atrioventricular nodal reentrant tachycardia.