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Remote magnetic navigation vs. manual navigation for ablation of ventricular tachycardia: a meta-analysis

Background The purpose of this study was to prospectively evaluate the efficacy and safety of remote magnetic navigation (RMN) in comparison with manual catheter navigation (MCN) in performing ventricular tachycardia ablation. Methods An electronic search was performed using PubMed (1948–2013) and E...

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Published in:Netherlands heart journal 2015-09, Vol.23 (10), p.485-490
Main Authors: Wu, Y., Li, K.-L., Zheng, J., Zhang, C.-Y., Liu, X.-Y., Cui, Z.-M., Yu, Z.-M., Wang, R.-X., Wang, W.
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container_title Netherlands heart journal
container_volume 23
creator Wu, Y.
Li, K.-L.
Zheng, J.
Zhang, C.-Y.
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description Background The purpose of this study was to prospectively evaluate the efficacy and safety of remote magnetic navigation (RMN) in comparison with manual catheter navigation (MCN) in performing ventricular tachycardia ablation. Methods An electronic search was performed using PubMed (1948–2013) and EMBASE (1974–2013) studies comparing RMN with MCN which were published prior to 31 December 2013. Outcomes of interest were as follows: acute success, recurrence rate, complications, total procedure and fluoroscopic times. Standard mean difference (SMD) and its 95 % confidence interval (CI) were used for continuous outcomes; odds ratios (OR) were reported for dichotomous variables. Results Four non-randomised studies, including a total of 328 patients, were identified. RMN was deployed in 191 patients. Acute success and long-term freedom from arrhythmias were not significantly different between the RMN and control groups (OR 1.845, 95 % CI 0.731–4.659, p  = 0.195 and OR 0.676, 95 % CI 0.383–1.194, p  = 0.177, respectively). RMN was associated with less peri-procedural complications (OR 0.279, 95 % CI 0.092–0.843, p  = 0.024). Shorter procedural and fluoroscopy times were achieved (95 % CI -0.487 to -0.035, p  = 0.024 and 95 % CI -1.467 to -0.984, p
doi_str_mv 10.1007/s12471-015-0734-1
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Methods An electronic search was performed using PubMed (1948–2013) and EMBASE (1974–2013) studies comparing RMN with MCN which were published prior to 31 December 2013. Outcomes of interest were as follows: acute success, recurrence rate, complications, total procedure and fluoroscopic times. Standard mean difference (SMD) and its 95 % confidence interval (CI) were used for continuous outcomes; odds ratios (OR) were reported for dichotomous variables. Results Four non-randomised studies, including a total of 328 patients, were identified. RMN was deployed in 191 patients. Acute success and long-term freedom from arrhythmias were not significantly different between the RMN and control groups (OR 1.845, 95 % CI 0.731–4.659, p  = 0.195 and OR 0.676, 95 % CI 0.383–1.194, p  = 0.177, respectively). RMN was associated with less peri-procedural complications (OR 0.279, 95 % CI 0.092–0.843, p  = 0.024). Shorter procedural and fluoroscopy times were achieved (95 % CI -0.487 to -0.035, p  = 0.024 and 95 % CI -1.467 to -0.984, p &lt;0.001, respectively). Conclusion The acute and long-term success rates for VT ablation are equal between RMN and MCN, whereas the RMN-guided procedure can be performed with a lower complication rate and less procedural and fluoroscopic times. More prospective randomised trials will be needed to better evaluate the superior role of RMN for catheter ablation of ventricular tachycardia.</description><identifier>ISSN: 1568-5888</identifier><identifier>EISSN: 1876-6250</identifier><identifier>DOI: 10.1007/s12471-015-0734-1</identifier><identifier>PMID: 26215291</identifier><language>eng</language><publisher>Houten: Bohn Stafleu van Loghum</publisher><subject>Ablation ; Cardiac arrhythmia ; Cardiology ; Catheters ; Confidence intervals ; Medical Education ; Medicine ; Medicine &amp; Public Health ; Meta-analysis ; Original - Design Study ; Original Article - Design Study Article ; Radiation ; Success</subject><ispartof>Netherlands heart journal, 2015-09, Vol.23 (10), p.485-490</ispartof><rights>The Author(s) 2015</rights><rights>The Author(s) 2015. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-ee0057e14348140f1f5568c01b166e47f07bd477540dc2ad3a819d32c7297cc83</citedby><cites>FETCH-LOGICAL-c470t-ee0057e14348140f1f5568c01b166e47f07bd477540dc2ad3a819d32c7297cc83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2788792616/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2788792616?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,25753,27924,27925,37012,37013,44590,53791,53793,75126</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26215291$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wu, Y.</creatorcontrib><creatorcontrib>Li, K.-L.</creatorcontrib><creatorcontrib>Zheng, J.</creatorcontrib><creatorcontrib>Zhang, C.-Y.</creatorcontrib><creatorcontrib>Liu, X.-Y.</creatorcontrib><creatorcontrib>Cui, Z.-M.</creatorcontrib><creatorcontrib>Yu, Z.-M.</creatorcontrib><creatorcontrib>Wang, R.-X.</creatorcontrib><creatorcontrib>Wang, W.</creatorcontrib><title>Remote magnetic navigation vs. manual navigation for ablation of ventricular tachycardia: a meta-analysis</title><title>Netherlands heart journal</title><addtitle>Neth Heart J</addtitle><addtitle>Neth Heart J</addtitle><description>Background The purpose of this study was to prospectively evaluate the efficacy and safety of remote magnetic navigation (RMN) in comparison with manual catheter navigation (MCN) in performing ventricular tachycardia ablation. Methods An electronic search was performed using PubMed (1948–2013) and EMBASE (1974–2013) studies comparing RMN with MCN which were published prior to 31 December 2013. Outcomes of interest were as follows: acute success, recurrence rate, complications, total procedure and fluoroscopic times. Standard mean difference (SMD) and its 95 % confidence interval (CI) were used for continuous outcomes; odds ratios (OR) were reported for dichotomous variables. Results Four non-randomised studies, including a total of 328 patients, were identified. RMN was deployed in 191 patients. Acute success and long-term freedom from arrhythmias were not significantly different between the RMN and control groups (OR 1.845, 95 % CI 0.731–4.659, p  = 0.195 and OR 0.676, 95 % CI 0.383–1.194, p  = 0.177, respectively). RMN was associated with less peri-procedural complications (OR 0.279, 95 % CI 0.092–0.843, p  = 0.024). Shorter procedural and fluoroscopy times were achieved (95 % CI -0.487 to -0.035, p  = 0.024 and 95 % CI -1.467 to -0.984, p &lt;0.001, respectively). Conclusion The acute and long-term success rates for VT ablation are equal between RMN and MCN, whereas the RMN-guided procedure can be performed with a lower complication rate and less procedural and fluoroscopic times. 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Methods An electronic search was performed using PubMed (1948–2013) and EMBASE (1974–2013) studies comparing RMN with MCN which were published prior to 31 December 2013. Outcomes of interest were as follows: acute success, recurrence rate, complications, total procedure and fluoroscopic times. Standard mean difference (SMD) and its 95 % confidence interval (CI) were used for continuous outcomes; odds ratios (OR) were reported for dichotomous variables. Results Four non-randomised studies, including a total of 328 patients, were identified. RMN was deployed in 191 patients. Acute success and long-term freedom from arrhythmias were not significantly different between the RMN and control groups (OR 1.845, 95 % CI 0.731–4.659, p  = 0.195 and OR 0.676, 95 % CI 0.383–1.194, p  = 0.177, respectively). RMN was associated with less peri-procedural complications (OR 0.279, 95 % CI 0.092–0.843, p  = 0.024). Shorter procedural and fluoroscopy times were achieved (95 % CI -0.487 to -0.035, p  = 0.024 and 95 % CI -1.467 to -0.984, p &lt;0.001, respectively). Conclusion The acute and long-term success rates for VT ablation are equal between RMN and MCN, whereas the RMN-guided procedure can be performed with a lower complication rate and less procedural and fluoroscopic times. More prospective randomised trials will be needed to better evaluate the superior role of RMN for catheter ablation of ventricular tachycardia.</abstract><cop>Houten</cop><pub>Bohn Stafleu van Loghum</pub><pmid>26215291</pmid><doi>10.1007/s12471-015-0734-1</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Ablation
Cardiac arrhythmia
Cardiology
Catheters
Confidence intervals
Medical Education
Medicine
Medicine & Public Health
Meta-analysis
Original - Design Study
Original Article - Design Study Article
Radiation
Success
title Remote magnetic navigation vs. manual navigation for ablation of ventricular tachycardia: a meta-analysis
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