Remote-controlled magnetic ablation of a right anterolateral accessory pathway - the superior caval vein approach.

OBJECTIVE

An 18-year old male patient with recurrent supraventricular tachycardias was admitted for catheter ablation. Baseline ECG was consistent with right anterolateral accessory pathway (AP) conduction.

MATERIALS AND METHODS

The novel magnetic navigation system (MNS, Niobe Stereotaxis) in combination with a catheter advancer unit (Cardiodrive, Stereotaxis) allows a complete remote-controlled electrophysiologic study and ablation.

RESULTS

Despite accurate identification of the AP insertion site using the MNS, a stable catheter position was not achieved from the inferior caval vein. Therefore, the venous access was switched to the superior caval vein approach using the left subclavian vein. The same magnetic field vector now resulted in a perfectly stable catheter position, and application of radiofrequency current immediately blocked AP conduction.

CONCLUSION

This case demonstrates feasibility and safety of a complete remote-controlled ablation of a right-sided anterolateral accessory pathway using the superior approach in conjunction with the novel magnetic navigation system Niobe.