Comparative Study Of Radiofrequency Ablation For Typical Atrial Flutter Under The Treatments Of Magnetic Navigation And Manual Catheter

BackgroundAtrial flutter is caused by ectopic tachycardia due to large reentry in the atrium.Symptoms such as palpitations,dizziness,chest tightness,and shortness of breath will occur during the attack,which may cause myocardial ischemia,heart failure,thromboembolism,and even cardiogenic shock.The symptoms and complications need to be treated with drugs or surgery.Traditional manual catheter ablation can interrupt the reentry loop,which is the main method for the treatment of typical atrial flutter.And the successful rate can reach 92%.However,there is a large amount of radiation,inaccurate positioning,inaccurate mapping and complicated structure which is difficult to grasp.The radiofrequency ablation under the guidance of magnetic navigation system can solve these problems.Since 2003,the technology has become more and more mature so that it has been used for different types of arrhythmias.But there are few researches and reports nowadays in atrial flutter.In this article,the advantages and disadvantages of the ablation under the guidance of magnetic navigation system and traditional manual catheter system on typical atrial flutter are compared and analyzed todetermine whether there are differences in effectiveness and safety between the two groups.MethodsThis article was a retrospective study.It included patients after radiofrequency ablation of typical atrial flutter who were hospitalized in the Department of Cardiology of the Second Affiliated Hospital of Zhejiang University Medical College from2013-10-1 to 2019-2-1.17 patients were randomly selected into the magnetic navigation system group,and 17 into the traditional manual catheter ablation group.The X-ray exposure time,X-ray exposure dose,operation time,surgical success rate,atrial flutter recurrence rate,and complication rate were compared between the two groups.ResultsThe procedure time,the X-ray exposure time and dose of patients in the magnetic navigation system group were 99.00(72.50)min,3.09±2.01 min and 13.11(18.46)m Gy,which were 104.29±51.77min(P>0.05),6.28±4.68min(P<0.05)and 40.06±17.84 m Gy(P<0.05)in the traditional manual catheter ablation group.Compared with the manual group,the X-ray exposure time and dose was significantly reduced in the front group.But there was no statistical difference in the operation time between two groups.The effectiveness of the catheter ablation was evaluated by two aspects-successful surgery and atrial flutter recurrence.The successful operation was defined as complete bidirectional block of the inferior vena cava-tricuspid annulus isthmus.The recurrence was assessed after 12 months follow-up.We found that the success rates of two groups were all 100%.There were no relapse cases in the magnetic navigation system group and one in the traditional manual catheter ablation group,but there was no statistical difference(P> 0.05).The complications of radiofrequency ablation are divided into short-term and long-term.The short-term is defined as a week follow-up after operationand the long-term is 12 months.In the study,the short-term complications in the magnetic navigation system group included 1 case of acute left heart failure and 1 case of atrial fibrillation,and 1 case of atrial fibrillation for long-time.The complication rate was 17.65%.There were 2 cases of atrial fibrillation in the traditional manual group,which are long-term complications.The complication rate was 11.76%.There was no statistical difference between the two groups(P> 0.05).ConclusionsCompared with the traditional manual catheter ablation,the radiofrequency ablation under the guidance of magnetic navigation system significantly reduced radiation exposure in the catheter ablation of typical atrial flutter,but the operation time is similar.There is no difference in the success of the operation and the recurrence of atrial flutter,and the probability of post-operative complications is similar.It means that the typical atrial flutter radiofrequency ablation under the guidance of the magnetic navigation system is similar in effectiveness and safety to the traditional manual method.But it can significantly reduce the radiation exposure of patients and surgeons.