LAUSR

Introduction: The role of remote magnetic navigation (RMN) for ventricular tachycardia (VT) ablation is not well established. In this meta- analysis, we aim to evaluate the safety and efficacy of RMN vs manual navigation (MAN) for VT ablation. Methods: A comprehensive literature search in PubMed, Google Scholar and Cochrane Review from inception till November 9th, 2019 was performed. Studies reporting clinical outcomes comparing MAN vs RMN were included. Two investigators independently extracted the data and individual quality assessment was performed. Results were expressed as odds ratio (OR) for dichotomous outcomes and mean differences (MD) for continuous variables with 95% confidence intervals (CI). Results: Eight studies including a total of 861 patients (475 in RMN arm and 386 in MAN arm) were included in the final analysis. VT recurrence was significantly lower with RMN compared with MAN (OR 0.65, 95% CI 0.48-0.88, p= 0.005). Acute procedural success was significantly higher with RMN (OR 2.21, 95% CI 1.51-3.23, p < 0.0001). Total procedure time [MD -8.83, 95% CI -17.72- 0.05, p=0.05], fluoroscopy time [MD -10.24, 95% CI -12.28- -8.19, p= 0.00001), and complications [OR 0.36, 95% CI 0.18- 0.72, p= 0.003] were significantly lower in RMN compared to MAN. Conclusion: Results of our meta-analysis indicate that RMN is safer and more effective than MAN in patients with VT undergoing ablation. Further, randomized studies are needed to validate these findings.