Robotic magnetic-guided catheter ablation in patients with congenital heart disease: a systematic review and pooled analysis

ABSTRACT

Background

Robotic magnetic navigation (RMN) has emerged as a potential solution to overcome challenges associated with catheter ablation of arrhythmias in patients with congenital heart disease (CHD).

Objectives

To assess safety and efficacy of RMNguided catheter ablation in patients with CHD.

Design and Methods

A systematic review and pooled analysis was conducted on patients with CHD who underwent RMNguided catheter ablation. Random effects models were used to generate pooled estimates with the inverse variance method used for weighting studies.

Results

Twentyfour nonoverlapping records included 167 patients with CHD, mean age 36.5 years, 44.6% female. Type of CHD was simple in 27 (16.2%), moderate in 32 (19.2%), and complex in 106 (63.5%). A total of 202 procedures targeted 260 arrhythmias, the most common being macroreentrant atrial circuits. The mean procedural duration was 207.5 minutes, with a mean fluoroscopy time of 12.1 minutes. The pooled acute success rate was 89.2% [95% CI (77.8%, 97.4%)]. Freedom from arrhythmia recurrence was 84.5% [95% CI (72.5%, 94.0%)] over a mean follow-up of 24.3 months. The procedural complication rate was 3.5% with no complication attributable to RMN technology.

Conclusion

RMN-guided ablation appears to be safe and effective across a variety of arrhythmia substrates and types of CHD.

KEYWORDS:

• Arrhythmias
• catheter ablation
• congenital heart disease
• robotic magnetic navigation

Declaration of Interest

C Vô received a fellowship grant from the Fondation Saint-Luc. P Khairy is supported by the André Chagnon Research Chair in Electrophysiology and Congenital Heart Disease. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Conception and design: CV, SB, PK. Analysis and interpretation of data: CV, KB, PK. Drafting of the paper: CV, PK. Critical revision for intellectual content: SB, KB, CMG, BM, MHG, KD, AF. Final approval: CV, SB, KB, CMG, BM, MHG, KD, AF, PK. All authors agree to be accountable for all aspects of the work.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14779072.2023.2184798

Additional information

Funding

This paper was not funded.