OBJECTIVES: We assessed feasibility of magnetic catheter guidance in patients with atrial fibrillation(AF) undergoing circumferential pulmonary vein ablation( CPVA). BACKGROUND: No data are available on feasibility of remote navigation for AF ablation. METHODS: Forty patients underwent CPVA for symptomatic AF using th e NIOBE II remote magnetic system(Stereotaxis Inc., St. Louis, Missouri). Ablati on was performed with a 4-mm tip, magnetic catheter(65℃, maximum 50 W, 15 s). The catheter tip was guided by a uniform magnetic field(0.08-T), and a motor dr ive(Cardiodrive unit, Stereotaxis Inc.). Left atrium maps were created using an integrated CARTO RMT system(Stereotaxis Inc.). End point of ablation was voltage abatement >90%of bipolar electrogram amplitude. RESULTS: Remote ablation was s uccessful in 38 of 40 patients without complications. The median mapping and abl ation time was 152.5 min(range, 90 to 380 min) but was much longer in the first 12 patients(192.5 min vs. 148 min; p=0.012). Median ablation time was 49.5 min(r ange, 17 to 154 min), but it was much shorter in the last 28 patients than in th e first 12 patients(49 min vs. 70 min; p=0.021). Patients receiving remote ablat ion had longer procedure times than control patients(p< 0.001) with similar mapp ing time but shorter ablation time on right-sided pulmonary veins. Many more ma pping points regardless of their location were collected remotely(p< 0.001). CON CLUSIONS: Remote magnetic navigation for AF ablation is safe and feasible with a short learning curve. Although all pro cedures were performed by a highly experienced operator, remote AF ablation can be performed even by less experienced operators.
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