Bun Sok-Sithikun, Latcu Decebal Gabriel, Allouche Emna, Errahmouni Abdelkarim, Saoudi Nadir
From the Department of Cardiology, Princess Grace Hospital, Monaco (Principality).
Pacing Clin Electrophysiol. 2015 Mar;38(3):391-7. doi: 10.1111/pace.12533. Epub 2014 Oct 29.
Remote magnetic navigation is an emerging technology for atrial fibrillation (AF) ablation. General anesthesia (GA) has shown to be superior to local anesthesia (LA) for manual AF ablation in terms of catheter stability and lesion formation. We aimed at comparing GA with LA for remote magnetic AF ablation procedures.
All patients eligible for a remote magnetic ablation of AF were included in this study. Ninety patients (70% of the patients were male; age: 60 ± 10 years; CHA2 DS2 -VASC : 1.6 ± 1.2; paroxysmal AF: 60%, persistent AF: 40%), including 45 patients with GA, and 45 patients with LA were enrolled consecutively.
There was no significant difference in total procedure time between the two groups (237 ± 50 minutes in the GA group vs 240 ± 61 minutes in the LA group; P = 0.84). Fluoroscopy time was significantly increased in the GA group (14.6 ± 6 minutes vs 11.6 ± 6 minutes, P = 0.018). Ablation time was not different between the two groups (2,320 ± 984 seconds in the GA group vs 2,055 ± 1,023 seconds in the LA group; P = 0.25). After a mean follow-up of 1 year (including repeat procedures), 39/45 patients (86.6%) within the GA group were free from recurrences versus 40/45 patients (88.8%) in the LA group (P = 0.74) without antiarrhythmic drugs.
For remote magnetic AF ablation, procedures under LA have similar results to GA in terms of efficacy and safety after 1-year follow-up.
远程磁导航是一种用于心房颤动（AF）消融的新兴技术。在手动AF消融中，全身麻醉（GA）在导管稳定性和损伤形成方面已显示出优于局部麻醉（LA）。我们旨在比较GA和LA用于远程磁AF消融手术的效果。
所有符合远程磁AF消融条件的患者均纳入本研究。连续纳入90例患者（70%为男性；年龄：60±10岁；CHA2 DS2 -VASC评分：1.6±1.2；阵发性AF：60%，持续性AF：40%），其中45例接受GA，45例接受LA。
两组总手术时间无显著差异（GA组为237±50分钟，LA组为240±61分钟；P = 0.84）。GA组的透视时间显著增加（14.6±6分钟对11.6±6分钟，P = 0.018）。两组间消融时间无差异（GA组为2320±984秒，LA组为2055±1023秒；P = 0.25）。平均随访1年（包括重复手术）后，GA组45例患者中有39例（86.6%）无复发，LA组45例患者中有40例（88.8%）无复发（P = 0.74），且均未使用抗心律失常药物。
对于远程磁AF消融，1年随访后，LA下手术在疗效和安全性方面与GA相似。
