First in-human results of the MAGiC robotic magnetic navigation radiofrequency ablation catheter.

Background: Robotic magnetic navigation (RMN) has demonstrated clinical utility in treating arrhythmia patients by providing direct distal-tip control of an ablation catheter, enhancing catheter precision, safety, and stability with an atraumatic catheter design. We aimed to assess the first in-human efficacy and safety of the new RMN-guided MAGiCTM radiofrequency ablation catheter.

Methods: This prospective, multicenter single-arm, unblinded study enrolled 67 patients with arrhythmias that met EHRA guidelines for catheter ablation. All patients were treated for their index arrhythmia with the MAGiC RMN catheter. All other devices used in the procedures were approved for treatment including a RMN System (Genesis/Niobe^®) used to navigate the MAGiC catheter. Acute procedural success and adverse events were assessed for all patients through discharge from the hospital in the days following the procedure.

Results: Sixty-seven patients were treated as follows: 25 cases of atrioventricular nodal reentrant tachycardia, 19 of premature ventricular contractions, 8 of Wolf-Parkinson-White (WPW) syndrome, 8 of atrial fibrillation, 3 of atrial flutter, and 4 of ventricular tachycardia. Acute procedural success was 94%. There was one cardiac tamponade due to perforation of the right ventricular outflow tract during ablation. Otherwise, no adverse events were observed.

Conclusion: The results of this study demonstrate good acute efficacy and safety of the MAGiC RMN ablation catheter independent of underlying arrhythmias. Contact force and stability with MAGiC seem improved compared to previous catheters available with RMN, and therefore radiofrequency energy delivery needs careful attention, especially in thin areas of the myocardium. Additional long-term data are needed.