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| ⚫ | '''Robotic magnetic navigation''' ('''RMN''') (also called remote magnetic navigation) uses robotic technology to direct magnetic fields which control the movement of magnetic-tipped endovascular catheters into and through the chambers of the heart during [[cardiac catheterization]] procedures.<ref>{{cite journal |last1=Da Costa |first1=A |last2=Guichard |first2=JB |last3=Roméyer-Bouchard |first3=C |last4=Gerbay |first4=A |last5=Isaaz |first5=K |title=Robotic magnetic navigation for ablation of human arrhythmias |journal= Medical Devices: Evidence and Research|date=2016 |volume=9 |pages=331–339 |doi=10.2147/MDER.S96167 |pmid=27698569|pmc=5034914 |doi-access=free }}</ref> |
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==Devices== |
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==Mechanism of Action== |
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| ⚫ | Because the human heart beats during ablation procedures, catheter stability can be affected by navigation technique. Magnetic fields created by RMN technology guide the tip of a catheter using a “pull” mechanism of action (as opposed to “push” with manual catheter navigation). Magnetic catheter navigation has been associated with greater catheter stability.<ref>{{cite journal |last1=Davis |first1=DR |last2=Tang |first2=AS |last3=Gollob |first3=MH |last4=Lemery |first4=R |last5=Green |first5=MS |last6=Birnie |first6=DH |title=Remote magnetic navigation-assisted catheter ablation enhances catheter stability and ablation success with lower catheter temperatures |journal=Pacing and Clinical Electrophysiology |date=July 2008 |volume=31 |issue=7 |pages=893–8 |doi=10.1111/j.1540-8159.2008.01105.x |pmid=18684288|s2cid=19617848 }}</ref> |
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===Magnetic Catheters=== |
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====Pull vs. Push==== |
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| ⚫ | Because the human heart beats during ablation procedures, catheter stability can be affected by navigation technique. Magnetic fields created by RMN technology guide the tip of a catheter using a “pull” mechanism of action (as opposed to “push” with manual catheter navigation). Magnetic catheter navigation has been associated with greater catheter stability.<ref>{{cite journal |last1=Davis |first1=DR |last2=Tang |first2=AS |last3=Gollob |first3=MH |last4=Lemery |first4=R |last5=Green |first5=MS |last6=Birnie |first6=DH |title=Remote magnetic navigation-assisted catheter ablation enhances catheter stability and ablation success with lower catheter temperatures |
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==Medical use== |
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===Atrial |
===Atrial fibrilation=== |
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As of 2015 there were two robotic catheterization systems on the market for [[atrial fibrilation]]; one of them used magnetic guidance.<ref>{{cite journal |last1=Gerstenfeld |first1=EP |last2=Duggirala |first2=S |title=Atrial fibrillation ablation: indications, emerging techniques, and follow-up |journal=Progress in Cardiovascular Diseases |date=2015 |volume=58 |issue=2 |pages=202–12 |doi=10.1016/j.pcad.2015.07.008 |pmid=26241304}}</ref> |
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After long-term follow up, RMN navigation has been associated with better procedural and clinical outcomes for AF ablation when compared with manual catheter navigation for cardiac ablation.<ref>{{cite journal |last1=Yuan |first1=S |last2=Holmqvist |first2=F |last3=Kongstad |first3=O |last4=Jensen |first4=SM |last5=Wang |first5=L |last6=Ljungström |first6=E |last7=Hertervig |first7=E |last8=Borgquist |first8=R |title=Long-term outcomes of the current remote magnetic catheter navigation technique for ablation of atrial fibrillation |
After long-term follow up, RMN navigation has been associated with better procedural and clinical outcomes for AF ablation when compared with manual catheter navigation for cardiac ablation.<ref>{{cite journal |last1=Yuan |first1=S |last2=Holmqvist |first2=F |last3=Kongstad |first3=O |last4=Jensen |first4=SM |last5=Wang |first5=L |last6=Ljungström |first6=E |last7=Hertervig |first7=E |last8=Borgquist |first8=R |title=Long-term outcomes of the current remote magnetic catheter navigation technique for ablation of atrial fibrillation |journal=Scandinavian Cardiovascular Journal |date=December 2017 |volume=51 |issue=6 |pages=308–315 |doi=10.1080/14017431.2017.1384566 |pmid=28958165|s2cid=25501499 }}</ref> |
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===Ventricular |
===Ventricular tachycardia=== |
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| ⚫ | RMN has been shown to be safe and effective for cardiac catheter ablation in various patient populations with [[ventricular tachycardia]].<ref>{{cite journal |last1=Turagam |first1=MK |last2=Atkins |first2=D |last3=Tung |first3=R |last4=Mansour |first4=M |last5=Ruskin |first5=J |last6=Cheng |first6=J |last7=Di Biase |first7=L |last8=Natale |first8=A |last9=Lakkireddy |first9=D |title=A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation |journal=Journal of Interventional Cardiac Electrophysiology |date=September 2017 |volume=49 |issue=3 |pages=227–235 |doi=10.1007/s10840-017-0257-3 |pmid=28624892|s2cid=21925778 }}</ref><ref>{{cite journal |last1=Akca |first1=F |last2=Önsesveren |first2=I |last3=Jordaens |first3=L |last4=Szili-Torok |first4=T |title=Safety and efficacy of the remote magnetic navigation for ablation of ventricular tachycardias--a systematic review |journal=Journal of Interventional Cardiac Electrophysiology |date=June 2012 |volume=34 |issue=1 |pages=65–71 |doi=10.1007/s10840-011-9645-2 |pmid=22180126|pmc=3342497 }}</ref> |
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Treatments for ventricular tachycardia include [[radiofrequency ablation]] in addition to pharmaceutical therapy and [[implantable cardioverter-defibrillator]] (ICD) implantation.<ref>{{cite web |title=Ventricular Tachycardia {{!}} Johns Hopkins Medicine Health Library |url=https://www.hopkinsmedicine.org/healthlibrary/conditions/cardiovascular_diseases/ventricular_tachycardia_22,VentricularTachycardia |website=www.hopkinsmedicine.org |accessdate=13 July 2018 |language=en}}</ref> |
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| ⚫ | RMN has been shown to be safe and effective for cardiac catheter ablation in various patient populations with [[ventricular tachycardia]].<ref>{{cite journal |last1=Turagam |first1=MK |last2=Atkins |first2=D |last3=Tung |first3=R |last4=Mansour |first4=M |last5=Ruskin |first5=J |last6=Cheng |first6=J |last7=Di Biase |first7=L |last8=Natale |first8=A |last9=Lakkireddy |first9=D |title=A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation |
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===Congenital Heart Disease=== |
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Cardiac arrhythmias are commonly associated with [[congenital heart disease]] (CHD), especially as individuals born with congenital cardiac defects live longer. Today, approximately 1 million adults are living with congenital heart disease in the United States.<ref>{{cite web |title=For Medical Professionals - Arrhythmias in adult congenital heart disease |url=https://www.mayoclinic.org/medical-professionals/clinical-updates/cardiovascular/arrhythmias-in-adult-congenital-heart-disease |website=Mayo Clinic |accessdate=13 July 2018 |language=en}}</ref> |
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Catheter ablation therapy for arrhythmias in patients with CHD is safe and feasible in children and young adults and is "especially valuable in patients with abnormal cardiac morphologies." RMN has also been associated with "significantly lower radiation exposure compared with the conventional technique" in ablation procedures for CHD-related arrhythmias.<ref>{{cite journal |last1=Roudijk |first1=RW |last2=Gujic |first2=M |last3=Suman-Horduna |first3=I |last4=Marchese |first4=P |last5=Ernst |first5=S |title=Catheter ablation in children and young adults: is there an additional benefit from remote magnetic navigation? |journal=Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation |date=June 2013 |volume=21 |issue=6 |pages=296–303 |doi=10.1007/s12471-013-0408-9 |pmid=23595705}}</ref> |
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==References== |
==References== |
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{{Reflist}} |
{{Reflist}} |
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[[Category:Medical technology]] |
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[[Category:Health sciences]] |
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Latest revision as of 11:14, 30 April 2024
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Robotic magnetic navigation (RMN) (also called remote magnetic navigation) uses robotic technology to direct magnetic fields which control the movement of magnetic-tipped endovascular catheters into and through the chambers of the heart during cardiac catheterization procedures.[1]
Devices
[edit]Because the human heart beats during ablation procedures, catheter stability can be affected by navigation technique. Magnetic fields created by RMN technology guide the tip of a catheter using a “pull” mechanism of action (as opposed to “push” with manual catheter navigation). Magnetic catheter navigation has been associated with greater catheter stability.[2]
Medical use
[edit]Atrial fibrilation
[edit]As of 2015 there were two robotic catheterization systems on the market for atrial fibrilation; one of them used magnetic guidance.[3]
After long-term follow up, RMN navigation has been associated with better procedural and clinical outcomes for AF ablation when compared with manual catheter navigation for cardiac ablation.[4]
Ventricular tachycardia
[edit]RMN has been shown to be safe and effective for cardiac catheter ablation in various patient populations with ventricular tachycardia.[5][6]
References
[edit]- ^ Da Costa, A; Guichard, JB; Roméyer-Bouchard, C; Gerbay, A; Isaaz, K (2016). "Robotic magnetic navigation for ablation of human arrhythmias". Medical Devices: Evidence and Research. 9: 331–339. doi:10.2147/MDER.S96167. PMC 5034914. PMID 27698569.
- ^ Davis, DR; Tang, AS; Gollob, MH; Lemery, R; Green, MS; Birnie, DH (July 2008). "Remote magnetic navigation-assisted catheter ablation enhances catheter stability and ablation success with lower catheter temperatures". Pacing and Clinical Electrophysiology. 31 (7): 893–8. doi:10.1111/j.1540-8159.2008.01105.x. PMID 18684288. S2CID 19617848.
- ^ Gerstenfeld, EP; Duggirala, S (2015). "Atrial fibrillation ablation: indications, emerging techniques, and follow-up". Progress in Cardiovascular Diseases. 58 (2): 202–12. doi:10.1016/j.pcad.2015.07.008. PMID 26241304.
- ^ Yuan, S; Holmqvist, F; Kongstad, O; Jensen, SM; Wang, L; Ljungström, E; Hertervig, E; Borgquist, R (December 2017). "Long-term outcomes of the current remote magnetic catheter navigation technique for ablation of atrial fibrillation". Scandinavian Cardiovascular Journal. 51 (6): 308–315. doi:10.1080/14017431.2017.1384566. PMID 28958165. S2CID 25501499.
- ^ Turagam, MK; Atkins, D; Tung, R; Mansour, M; Ruskin, J; Cheng, J; Di Biase, L; Natale, A; Lakkireddy, D (September 2017). "A meta-analysis of manual versus remote magnetic navigation for ventricular tachycardia ablation". Journal of Interventional Cardiac Electrophysiology. 49 (3): 227–235. doi:10.1007/s10840-017-0257-3. PMID 28624892. S2CID 21925778.
- ^ Akca, F; Önsesveren, I; Jordaens, L; Szili-Torok, T (June 2012). "Safety and efficacy of the remote magnetic navigation for ablation of ventricular tachycardias--a systematic review". Journal of Interventional Cardiac Electrophysiology. 34 (1): 65–71. doi:10.1007/s10840-011-9645-2. PMC 3342497. PMID 22180126.