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Safety and Long‐Term Outcomes of Catheter Ablation of Atrial Fibrillation Using Magnetic Navigation versus Manual Conventional Ablation: A Propensity‐Score Analysis
Author(s) -
ADRAGÃO PEDRO PULIDO,
CAVACO DIOGO,
FERREIRA ANTÓNIO MIGUEL,
COSTA FRANCISCO MOSCOSO,
PARREIRA LEONOR,
CARMO PEDRO,
MORGADO FRANCISCO BELLO,
SANTOS KATYA REIS,
SANTOS PEDRO GALVÃO,
CARVALHO MARIA SALOMÉ,
DURAZZO ANAI,
MARQUES HUGO,
GONÇALVES PEDRO ARAÚJO,
RAPOSO LUÍS,
MENDES MIGUEL
Publication year - 2016
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.12900
Subject(s) - medicine , propensity score matching , ablation , atrial fibrillation , catheter ablation , hazard ratio , ablation of atrial fibrillation , cardiology , refractory (planetary science) , confidence interval , surgery , physics , astrobiology
Magnetic versus Manual Ablation of Atrial Fibrillation Introduction Whether or not the potential advantages of using a magnetic navigation system (MNS) translate into improved outcomes in patients undergoing atrial fibrillation (AF) ablation is a question that remains unanswered. Methods and Results In this observational registry study, we used propensity‐score matching to compare the outcomes of patients with symptomatic drug‐refractory AF who underwent catheter ablation using MNS with the outcomes of those who underwent catheter ablation using conventional manual navigation. Among 1,035 eligible patients, 287 patients in each group had similar propensity scores and were included in the analysis. The primary efficacy outcome was the rate of AF relapse after a 3‐month blanking period. At a mean follow‐up of 2.6 ± 1.5 years, AF ablation with MNS was associated with a similar risk of AF relapse as compared with manual navigation (18.4% per year and 22.3% per year, respectively; hazard ratio 0.81, 95% CI 0.63–1.05; P = 0.108). Major complications occurred in two patients (0.7%) using MNS, and in six patients (2.1%) undergoing manually navigated ablation (P = 0.286). Fluoroscopy times were 21 ± 10 minutes in the manual navigation group, and 12 ± 9 minutes in the MNS group (P < 0.001), whereas total procedure times were 152 ± 52 minutes and 213 ± 58 minutes, respectively (P < 0.001). Conclusions In this propensity‐score matched comparison, magnetic navigation and conventional manual AF ablations seem to have similar relapse rates and a similar risk of complications. AF ablations with magnetic navigation take longer to perform but expose patients to significantly shorter fluoroscopy times.