Differences in feasibility and outcomes of catheter ablation using robotic magnetic navigation in patients with congenital heart disease depending on the complexity of the defect

Introduction Robotic magnetic navigation (RMN) allows catheter ablation in the presence of a difficult cardiac anatomy such as congenital heart diseases (CHD). The objective of this study is to evaluate the feasibility, efficacy and safety of this procedure depending on the complexity of defect. Methods Patients with CHD, who underwent catheter ablation of cardiac arrhythmia with the use of RMN, were included. Patients baseline characteristics, procedural data, periprocedural complications and acute success rates were obtained. Efficacy of the ablation was evaluated during follow-up in the outpatient clinic with the use of 24-hour Holter monitoring. Results Study population consisted of 38 patients (26 males) with a median age of 36.8 (IQR 30.8-39.6). Surgically corrected transposition of the great arteries was the most common CHD, that occurred in 14 patients (36.8%). Nineteen patients (50.0%) had more than one congenital defect. Atrial flutter was the most common arrythmia ablated in 21 procedures (55.3%). Mean procedural time was 322.9 minutes (SD 99.3), median radiation dose and radiation time were 2.4 mGym 2 (IQR 1.3-4.4) and 14.0 minutes (IQR 9.5-30.4), respectively. Acute arrhythmia cessation was observed during 81.6% of procedures. Major complications were noted in 2 cases (5.3%). Median time from the ablation to follow-up was 5.4 months (IQR 3.4-9.3). Arrhythmia recurrence was observed in 7 cases (18.4%). Conclusions RMN is a valuable tool for catheter ablation for arrhythmias in patients with congenital heart disease and complex anatomy.