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Remotely controlled steerable sheath improves result and procedural parameters of atrial fibrillation ablation with magnetic navigation.

Errahmouni A, Latcu DG, Bun SS, Rijo N, Dugourd C, Saoudi N - Europace (2015)

Bottom Line: No complication occurred in RSh group.During follow-up, there were five recurrences (11%) in RSh group and 11 (29%) in CAS group (P = 0.027).Right PV isolation is faster, RF delivery time and procedure time are reduced.

View Article: PubMed Central - PubMed

Affiliation: Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur 98000, Monaco a.errahmouni@gmail.com.

No MeSH data available.


Related in: MedlinePlus

A loop with the robotic sheath in the LA was systematically used for targeting the ostia of the right PVs: (A) antero-posterior fluoroscopic image; (B) map of the LA; and (C) merge with the computed tomographic scan reconstruction of the LA.
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EUU388F2: A loop with the robotic sheath in the LA was systematically used for targeting the ostia of the right PVs: (A) antero-posterior fluoroscopic image; (B) map of the LA; and (C) merge with the computed tomographic scan reconstruction of the LA.

Mentions: Ablation strategy was circumferential antral PVI (CPVI) in paroxysmal AF (PAF) with lasso-proven PVI as an endpoint. Radiofrequency (RF) was delivered in a point-by-point manner with minimum 30 s burns (aiming electrograms (EGMs) modification favouring transmural lesion) at each ablation site.3 Robotic deflectable sheath loop in the LA was systematically used for targeting the ostia of the right PV (Figure 2). A stepwise approach was used for persistent AF patients, with additional lesions targeting fractionated EGMs in the LA, inside the coronary sinus and in the right atrium (RA), as well as LA roof and in some cases left isthmus lines. In case of AF termination by transformation into an atrial tachycardia, the critical isthmus of conduction was localized and targeted with the endpoint of sinus rhythm restoration; if AF persisted after ablation of all suitable sites, an electrical cardioversion was performed within 48 h after the procedure. An electroanatomical mapping system was used for all procedures (Carto 3, Biosense Webster Inc.). Circumferential antral PVI was performed in all patients, as widely in the antrum as possible, with the endpoint of abolition or dissociation of activities in the PVs (entrance block). Pulmonary vein potentials were distinguished from eventual far-field potentials with pacing techniques from the left atrial appendage, or RA.Figure 2


Remotely controlled steerable sheath improves result and procedural parameters of atrial fibrillation ablation with magnetic navigation.

Errahmouni A, Latcu DG, Bun SS, Rijo N, Dugourd C, Saoudi N - Europace (2015)

A loop with the robotic sheath in the LA was systematically used for targeting the ostia of the right PVs: (A) antero-posterior fluoroscopic image; (B) map of the LA; and (C) merge with the computed tomographic scan reconstruction of the LA.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482286&req=5

EUU388F2: A loop with the robotic sheath in the LA was systematically used for targeting the ostia of the right PVs: (A) antero-posterior fluoroscopic image; (B) map of the LA; and (C) merge with the computed tomographic scan reconstruction of the LA.
Mentions: Ablation strategy was circumferential antral PVI (CPVI) in paroxysmal AF (PAF) with lasso-proven PVI as an endpoint. Radiofrequency (RF) was delivered in a point-by-point manner with minimum 30 s burns (aiming electrograms (EGMs) modification favouring transmural lesion) at each ablation site.3 Robotic deflectable sheath loop in the LA was systematically used for targeting the ostia of the right PV (Figure 2). A stepwise approach was used for persistent AF patients, with additional lesions targeting fractionated EGMs in the LA, inside the coronary sinus and in the right atrium (RA), as well as LA roof and in some cases left isthmus lines. In case of AF termination by transformation into an atrial tachycardia, the critical isthmus of conduction was localized and targeted with the endpoint of sinus rhythm restoration; if AF persisted after ablation of all suitable sites, an electrical cardioversion was performed within 48 h after the procedure. An electroanatomical mapping system was used for all procedures (Carto 3, Biosense Webster Inc.). Circumferential antral PVI was performed in all patients, as widely in the antrum as possible, with the endpoint of abolition or dissociation of activities in the PVs (entrance block). Pulmonary vein potentials were distinguished from eventual far-field potentials with pacing techniques from the left atrial appendage, or RA.Figure 2

Bottom Line: No complication occurred in RSh group.During follow-up, there were five recurrences (11%) in RSh group and 11 (29%) in CAS group (P = 0.027).Right PV isolation is faster, RF delivery time and procedure time are reduced.

View Article: PubMed Central - PubMed

Affiliation: Cardiologie, Centre Hospitalier Princesse Grace, Avenue Pasteur 98000, Monaco a.errahmouni@gmail.com.

No MeSH data available.


Related in: MedlinePlus