Magnetically Navigated vs. Manually Guided Radiofrequency in Atrioventricular-node-reentry-tachycardia

AV-node reentry tachycardia can be treated by radiofrequency ablation or modulation of the slow pathway of the av node. The success rate is 90 to 95%.

There are different options to navigate the ablation catheter: manually guided vs magnetically guided.

For magnetic guidance two magnets are positioned beneath the patient. A mangetic field is induced and a catheter with a ferromagnetic tip can be navigated from outside with a joystick by modifying the vectors of the magnetic field.

We hypothesized that a magnetic guidance of the RF-ablation catheter results in lower x-ray time and dose for the patient and the physician with comparable safety und success rates.

• RF-ablation (Procedure): 4mm-tip catheter manually guided vs magneticallly navigated

Primary outcomes

• Total x-ray time and dose for patient [electrophysiological examination]

Secondary outcomes

• X-ray time and dose for physician [electrophysiological study]
• Safety of ablation (AV-Block, perforation) [end of electrophysiological study]
• short-term and long-term-success [end of procedure and 6 months after procedure]
• number of RF-application [procedure]
• Duration of electrophysiological study (ablation included) [procedure]

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* 18 to 70 years old
* suspected AV-node-reentry-tachycardia
* written informed consent

Exclusion Criteria:

* pregnancy
* contraindication against electrophysiological study or ablation
* congenital heart disease or other anatomical abnormalities
* previous surgical procedure involving atrium except aorto-coronary bypass grafts
* psychiatric disease that makes a completion of study improbable
* severe comorbidities with a life expectancy less than 6 months

• Gabi Hessling, MD, Study chair, Deutsches Herzzentrum München
• Peter Schuster, MD, Study chair, University of Bergen
• Isabel Deisenhofer, MD, Study chair, Deutsches Herzzentrum München