Remote controlled magnetically guided pulmonary vein isolation in canines

BACKGROUND Ablation of atrial fibrillation (AF) remains a challenging procedure fraught with significant risks and technical difficulties. A magnetically guided catheter system has been developed that potentially addresses many of these challenges. Fully remote controlled electrical isolation of pulmonary veins was performed in canines, facilitated by a three-dimensional computed tomogram (CT) that depicted the anatomic relationships of the pulmonary veins and the left atrium. OBJECTIVE The purpose of this study was to evaluate the feasibility of pulmonary vein isolation with a novel remote controlled magnetically guided catheter. METHODS CT scans were obtained in seven healthy male canines. A 7-Fr irrigated magnetic catheter was advanced transseptally to the left atrium. A magnetic guidance system was used to control the orientation of the catheter tip. A mechanical device advanced or retracted the catheter as needed. Pulmonary venography was performed and compared with the CT scan. The CT scan was used as a visual reference to set the magnetic field vectors. Radiofrequency energy was delivered through the irrigated magnetic catheter to isolate the superior pulmonary veins, as judged by elimination of pulmonary vein potentials. RESULTS The isolation procedure was successful in all 14 pulmonary veins, and there was no evidence of stenosis at 80-100 days postprocedure. CONCLUSIONS These results demonstrate that remote controlled catheter ablation is safe and effective for segmental pulmonary vein isolation. This technology could facilitate curative ablation of AF in humans and reduce the occupational hazards to the operator of prolonged procedures and radiation exposure.