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Volume 50, Issue 9 , Pages 868-874 , 28 August 2007

Remote Magnetic Navigation: Human Experience in Pulmonary Vein Ablation

Luigi Di Biase, MD
- Dr. Di Biase was supported by a grant from the Italian Society of Cardiology (SIC).
Tamer S. Fahmy, MD
Dimpi Patel, MD
Rong Bai, MD
Kenneth Civello, MD
Oussama M. Wazni, MD
Mohamed Kanj, MD
Claude S. Elayi, MD
Chi Keong Ching, MD
Mohamed Khan, MD
Lucie Popova, MD
- Dr. Popova was supported by a grant from Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Robert A. Schweikert, MD
Jennifer E. Cummings, MD
J. David Burkhardt, MD
David O. Martin, MD
Mandeep Bhargava, MD
Thomas Dresing, MD
Walid Saliba, MD
Mauricio Arruda, MD
Andrea Natale, MD
- Reprint requests and correspondence: Dr. Andrea Natale, Head, Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195.

Received 14 February 2007 ,Revised 17 April 2007 ,Accepted 14 May 2007.

Magnetic Navigation Field Directions
The green arrow (vector) indicates the direction of the magnetic field, as projected onto the respective X-ray image plane.

Magnetic Navigation Field Directions
The green arrow (vector) indicates the direction of the magnetic field, as projected onto the respective X-ray image plane.
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Intracardiac Electrograms
Showing no differences in the pulmonary vein potentials before (A) and after (B) ablation with step 1 using remote magnetic navigation.

Intracardiac Electrograms
Showing no differences in the pulmonary vein potentials before (A) and after (B) ablation with step 1 using remote magnetic navigation.
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Views of the Charring on the Ablation Catheter
Charring at the catheter tip could be a source of embolism.

Views of the Charring on the Ablation Catheter
Charring at the catheter tip could be a source of embolism.
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Another View of the Charring on the Ablation Catheter

Another View of the Charring on the Ablation Catheter
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Ablation Strategy and Results
Flow chart showing the ablation strategy. After a mean follow-up period of 11 ± 2 months, 25 patients (55%) had recurrence. Out of the 22 patients who had only right pulmo

Ablation Strategy and Results
Flow chart showing the ablation strategy. After a mean follow-up period of 11 ± 2 months, 25 patients (55%) had recurrence. Out of the 22 patients who had only right pulmonary vein (PV) isolation by the conventional approach, 20 patients (90%) had recurrence of atrial fibrillation, whereas only 5 patients (22%) out of the 23 patients who had complete isolation with the conventional approach had recurrence (p < 0.001). CPVA = circumferential pulmonary vein ablation; MN = magnetic navigation; PVAI = pulmonary vein antral isolation; RPV = right pulmonary vein.
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