Ablação de arritmias da câmara de saída do ventrículo direito e esquerdo com sistema de navegação magnética por controlo remoto

Leonor Parreira, Diogo Cavaco, Katya Reis-Santos, Pedro Carmo, David Cabrita, Mauricio Scanavacca, Pedro Adragão
2013 Revista Portuguesa de Cardiologia  
Objective: The aim of this study was to assess the efficacy and potential complications of a remote-controlled magnetic navigation system (Niobe II, Stereotaxis) for mapping and ablation of right or left ventricular outflow tract ventricular tachycardia or premature ventricular contractions. Methods: We studied 32 consecutive patients, mean age 43±11 years, 24 female. Mapping of the arrhythmia was performed using the CARTO RMT mapping system, remotely guided by the Niobe II. Radiofrequency
more » ... Radiofrequency ablation was performed at the site of earliest ventricular activation with pacemapping of at least 11/12 leads. Acute success was defined as suppression and non-inducibility of the arrhythmia after stimulation with isoprenaline. After a minimum 3-month follow-up, we assessed clinical success (absence of symptoms and suppression of the arrhythmia on Holter recording), defined as less than 50 premature ventricular contractions/24 hours. Results: The origin of the arrhythmia was in the right ventricular outflow tract in 28 patients (88%), in the left in three, and in the epicardium in one. Acute success was achieved in 26 patients (81%). Two patients underwent a second successful procedure, in one of which an epicardial approach was necessary. The overall clinical success rate, after two repeat procedures, was 88%. No complications occurred. There were two recurrences during a mean follow-up of 307±204 days. Conclusion: The Niobe II remote control system for mapping and ablation of ventricular outflow tract arrhythmias is effective and safe, and provides precise mapping and a high success rate, with no complications.
doi:10.1016/j.repc.2012.12.012 pmid:23790283 fatcat:a6dssihtmrgc3ja7f7xjk35w3m