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Comparative Study
. 2019 Apr;42(4):418-424.
doi: 10.1002/clc.23156. Epub 2019 Mar 15.

Comparisons of efficacy, safety, and recurrence risk factors of paroxysmal and persistent atrial fibrillation catheter ablation using robotic magnetic navigation system

Xiao-Xi Zhao  1   2 , Ku-Lin Li  2 , Ru-Xing Wang  2 , Jie Zheng  2 , Xiao-Yu Liu  2 , Shi-Peng Dang  2 , Zhi-Ming Yu  2 , Chang-Ying Zhang  2 , Xiang-Jun Yang  1
Affiliations
Comparative Study

Comparisons of efficacy, safety, and recurrence risk factors of paroxysmal and persistent atrial fibrillation catheter ablation using robotic magnetic navigation system

Xiao-Xi Zhao et al. Clin Cardiol. 2019 Apr.

Abstract

Background: No data exist on comparisons of efficacy, safety, and recurrence risk factors of paroxysmal and persistent atrial fibrillation (AF) ablation using robotic magnetic navigation system (MNS), respectively.

Methods: About 151 AF patients were prospectively enrolled and divided into paroxysmal AF group (n = 102) and persistent AF group (n = 49). Circumferential pulmonary vein antrum isolation (CPVI) was performed in all patients. Linear ablation at the left atrial roof and mitral isthmus was performed in patients with persistent AF in addition to CPVI. The procedural time, X-ray exposure time, acute and long-term success rates of CPVI, and procedure-related complications were analyzed. The AF recurrence rates in the two groups were compared during 1 year, and Cox regression was used to analyze the recurrence risk factors.

Results: The acute success rates of CPVI in the two groups were 98.04% and 97.96%, respectively. There were no significant differences in the procedural time, X-ray exposure time, and ablation time between the two groups (P > 0.05). No serious complications appeared in either group. The AF ablation success rates were 70.6% and 57.1% for the paroxysmal and persistent groups respectively at 12-month follow-up (P = 0.102). AF duration and coronary heart disease prior to ablation were associated with the higher AF recurrence in patients with persistent AF.

Conclusion: Ablation using MNS is effective and safe both in patients with paroxysmal and persistent AF. AF duration and coronary heart disease prior to ablation are two independent risk factors of AF recurrence in patients with persistent AF postoperatively.

Keywords: atrial fibrillation; catheter ablation; magnetic navigation system; recurrence; risk factor.

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Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Catheter ablation of paroxysmal (left) and persistent (right) atrial fibrillation using magnetic navigation system. Left panel is paroxysmal atrial fibrillation ablation using magnetic navigation system, and the ablation protocol is only circumferential pulmonary vein antrum isolation. Right panel is persistent atrial fibrillation ablation using magnetic navigation system, and the ablation protocol is the linear ablation of mitral isthmus and left atrial roof in addition to circumferential pulmonary vein antrum isolation. The upper panel and the lower panel in left and right are the pictures at the same time, but the upper panel can simultaneously show three‐dimensional model of left atrium and ablation lines on fluoroscopy monitor, and the lower panel only shows ablation lines on fluoroscopy monitor
Figure 2
Figure 2
Kaplan‐Meier curve of atrial fibrillation recurrence after ablation using magnetic navigation system. A Kaplan‐Meier analysis was used to compare the probability of atrial fibrillation recurrence between the two groups. The Kaplan‐Meier analysis showed that the incidences of freedom from atrial fibrillation were 70.6% and 57.1% in patients with paroxysmal atrial fibrillation and paroxysmal atrial fibrillation respectively after 12‐month follow‐up
See this image and copyright information in PMC

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