Akca Ferdi, Önsesveren Ibrahim, Jordaens Luc, Szili-Torok Tamas
Clinical Electrophysiology, Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
J Interv Card Electrophysiol. 2012 Jun;34(1):65-71. doi: 10.1007/s10840-011-9645-2. Epub 2011 Dec 20.
Remote magnetic navigation (RMN) is considered to be a solution for mapping and ablation of several arrhythmias. In this systematic review we aimed to assess the safety and efficacy of RMN in ablation of ventricular tachycardia (VT).
The National Library of Medicine's PubMed database was searched for articles containing any of a predetermined set of search terms that were published prior to November 1, 2011. Quality of evidence was rated using the GRADE system.
The database search resulted in 11 relevant articles evaluating the usefulness of RMN. Three groups of VTs were studied: VT in patients with ischemic cardiomyopathy (ICMP), non-ischemic cardiomyopathy (NICMP) and structurally normal hearts (SNH). The use of RMN in patients with ICMP has been associated with success rates ranging from 71 to 80%. RMN has been shown to be a feasible and effective method for ablation of VT in NICMP and SNH patients. Success rates between 50% and 100% have been reported in NICMP populations. Rates ranging from 86% to 100% have been reported for SNH patients. The lowest rates of arrhythmia recurrence are reported for SNH patients (0-17%). In ICMP and NICMP, recurrence rates of 0-30% and 14-50%, respectively, have been reported. One patient experienced total heart block, and one patient experienced a thromboembolic event after RMN catheter ablation procedures.
RMN has been shown to be an effective and safe method for ablation of VT in various patient populations with low recurrence and complication rates. However, more comparative and randomized studies are necessary, and therefore the true value of RMN for VT ablation remains still unknown.
远程磁导航（RMN）被认为是一种用于多种心律失常标测和消融的解决方案。在本系统评价中，我们旨在评估RMN在室性心动过速（VT）消融中的安全性和有效性。
检索美国国立医学图书馆的PubMed数据库，查找2011年11月1日前发表的包含一组预定检索词中任何一个的文章。使用GRADE系统对证据质量进行评级。
数据库检索得到11篇评估RMN效用的相关文章。研究了三组室性心动过速：缺血性心肌病（ICMP）患者的室性心动过速、非缺血性心肌病（NICMP）患者的室性心动过速和心脏结构正常（SNH）患者的室性心动过速。在ICMP患者中使用RMN的成功率为71%至80%。RMN已被证明是一种用于NICMP和SNH患者VT消融的可行且有效的方法。在NICMP人群中报告的成功率为50%至100%。SNH患者的成功率报告为86%至100%。SNH患者的心律失常复发率最低（0 - 17%）。在ICMP和NICMP中，复发率分别报告为0 - 30%和14 - 50%。一名患者在RMN导管消融术后发生完全性心脏传导阻滞，一名患者发生血栓栓塞事件。
RMN已被证明是一种在各种患者群体中用于VT消融的有效且安全的方法，复发率和并发症发生率较低。然而，需要更多的比较性和随机研究，因此RMN在VT消融中的真正价值仍然未知。
