Department of Electrophysiology, University of Leipzig, Heart Center, Leipzig, Germany.
J Cardiovasc Electrophysiol. 2009 Aug;20(8):935-9. doi: 10.1111/j.1540-8167.2008.01416.x. Epub 2009 Jan 9.
A remote magnetic navigation system (MNS) has been used with a nonirrigated magnetic catheter for ablation of some supraventricular and ventricular arrhythmias. However, the irrigated tip catheter has not been evaluated.
To evaluate the feasibility and efficiency of the newly available irrigated tip magnetic catheter for radiofrequency ablation (RF) of electrical storm due to scar-related ventricular tachycardia (VT) in patients with ischemic heart disease.
Between January and March 2008, a total of 4 consecutive patients (4 men, mean age 67.7 years) with electrical storm who had an implantable cardioverter defibrillator underwent radiofrequency ablation using a remote MNS and the new magnetic irrigated catheter.
Five ablation procedures were performed in study patients. Acute success, defined as noninducibility of any monomorphic VT, was obtained in 3 patients. In 1 patient, a nonclinical VT remained inducible. A monomorphic VT corresponding to clinical VT with the median (range) cycle length of 485 (440-580) ms was induced in all patients. The duration of ablation was 2,273 (985-3087) seconds, with median total procedure and fluoroscopy times of 135 (100-150) minutes and 6.5 (5-9) minutes, respectively. One recurrence occurred 1 week after ablation, which was ablated successfully in the second session. No complication was observed after ablation. During mean follow-up of 4.2 months, all patients were in sinus rhythm, they received no ICD therapy, and no mortality occurred.
Irrigated ablation of scar-related ventricular tachycardia guided by remote MNS is a feasible and effective modality for management of the electrical storm in patients with ischemic cardiomyopathy with minimal radiation exposure.
一种远程磁导航系统（MNS）已与非灌流磁导管联合应用于某些室上性和室性心律失常的消融治疗。然而，尚未对灌流尖端导管进行评估。
评估新型灌流尖端磁导管用于经射频消融（RF）治疗缺血性心脏病患者因瘢痕相关室性心动过速（VT）所致电风暴的可行性和有效性。
2008 年 1 月至 3 月，4 例连续发生电风暴的患者（4 例男性，平均年龄 67.7 岁）接受了植入式心脏复律除颤器治疗，并使用远程 MNS 和新的磁性灌流导管进行了射频消融。
在研究患者中进行了 5 次消融手术。3 例患者获得急性成功，定义为任何单形性 VT 均不能诱发。1 例患者仍可诱发非临床 VT。所有患者均诱发出与临床 VT 相对应的单形性 VT，其平均（范围）周期长度为 485（440-580）ms。消融时间为 2273（985-3087）s，总手术和透视时间中位数分别为 135（100-150）min 和 6.5（5-9）min。1 例患者在消融后 1 周复发，第二次消融治疗成功。消融后无并发症发生。在平均 4.2 个月的随访期间，所有患者均保持窦性心律，未接受 ICD 治疗，且无死亡发生。
在远程 MNS 引导下，对瘢痕相关室性心动过速进行灌流消融治疗是一种可行且有效的方法，可用于管理缺血性心肌病患者的电风暴，且辐射暴露最小。
