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The Niobe® magnetic navigation system enables safe and successful treatment of patients with congenital diseases and offers exceptional results with low fluoroscopy use despite anatomical complexity.

The magnetic navigation system also delivers world-class results for even the smallest pediatric patients, providing the ability to navigate where manual catheters cannot go while minimizing childhood exposure to dangerous radiation.

The two scientific publications below highlight the safety and positive outcomes in treating congenital and pediatric patients using the magnetic navigation system.

{Congenital}
Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease: A Single-Center Experience in 116 Patients.

Ueda A, Suman-Horduna I, Mantziari L, Gujic M, Marchese P, Ho SY, Babu-Narayan SV, Ernst S.  
Circ Arrhythm Electrophysiol (2013) 6, 606-613.
Highlights:
  • The combination of remote magnetic navigation, 3D-image integration, and electroanatomic mapping facilitated safe and feasible ablation. 
  • These innovations provided very low fluoroscopy exposure even in congenital patients with complex anatomic anomalies. 

Abstract

BACKGROUND
Remote magnetic navigation-guided ablation with 3-dimensional (3D)-image integration could provide maximum benefit in patients with complex anatomy. We reviewed supraventricular tachycardia (SVT) ablation in adult patients with congenital heart disease to assess the contribution of these technologies.

METHODS AND RESULTS
One hundred fifty-four SVT ablation procedures (228 SVTs) using a 3D-electroanatomic mapping system in 116 adult patients with congenital heart disease (mean age, 41; 76 male) were classified into 3 groups: Group A, manual mapping/ablation (n=60 procedures); Group B, remote magnetic navigation-guided mapping/ablation with normal femoral vein access (49); and Group C, remote magnetic navigation-guided mapping/ablation with difficult access (45). Group A included simple anomalies with less SVTs. Group B comprised predominantly Fontan patients with more SVTs. Group C included more complex defects, such as intra-atrial baffle or interrupted inferior venous access, in which retrograde aortic and superior venous accesses were used exclusively with more frequent use of image integration (97.8%; P<0.001). Acute success was 91.5%, 83.7%, and 82.2%, respectively (P=0.370). In group C, fluoroscopy time was the shortest (median, 4.2 min; P<0.001) despite the longer procedure duration (median, 253 min; P<0.001). SVTs free rates were 80.4%, 82.4%, and 75.8%, respectively (P=0.787) during a mean 20-months follow-up period.

CONCLUSIONS
The combination of remote magnetic navigation, 3D-image integration, and electroanatomic mapping system facilitated safe and feasible ablation with very low fluoroscopy exposure even in patients with complex anomalies.

 

{Pediatrics}
Magnetic Versus Manual Catheter Navigation for Ablation of Free Wall Accessory Pathways in Children.

Kim JJ, Macicek SL, Decker JA, Kertesz NJ, Friedman RA, Cannon BC.  
Circ Arrhythm Electrophysiol (2012) 5, 804-808.
Highlights:
  • Magnetic navigation is a safe and effective approach to ablate accessory pathway mediated tachycardia in children. 

Abstract

BACKGROUND
Transcatheter ablation of accessory pathway (AP)-mediated tachycardia is routinely performed in children. Little data exist regarding the use of magnetic navigation (MN) and its potential benefits for ablation of AP-mediated tachycardia in this population.

METHODS AND RESULTS
We performed a retrospective review of prospectively gathered data in children undergoing radiofrequency ablation at our institution since the installation of MN (Stereotaxis Inc, St. Louis, MO) in March 2009. The efficacy and safety between an MN-guided approach and standard manual techniques for mapping and ablation of AP-mediated tachycardia were compared. During the 26-month study period, 145 patients underwent radiofrequency ablation for AP-mediated tachycardia. Seventy-three patients were ablated with MN and 72 with a standard manual approach. There were no significant differences in demographic factors between the 2 groups with a mean cohort age of 13.1±4.0 years. Acute success rates were equivalent with 68 of 73 (93.2%) patients in the MN group being successfully ablated versus 68 of 72 (94.4%) patients in the manual group (P=0.889). During a median follow-up of 21.4 months, there were no recurrences in the MN group and 2 recurrences in the manual group (P=0.388). There were no differences in time to effect, number of lesions delivered, or average ablation power. There was also no difference in total procedure time, but fluoroscopy time was significantly reduced in the MN group at 14.0 (interquartile range, 3.8-23.9) minutes compared with the manual group at 28.1 (interquartile range, 15.3-47.3) minutes (P<0.001). There were no complications in either group.

CONCLUSIONS
MN is a safe and effective approach to ablate AP-mediated tachycardia in children.

 

For more information on clinical publications, email info@stereotaxis.com.

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