Related Experiment Video
Updated: Jul 17, 2026
Remote Magnetic Navigation for Accurate, Real-time Catheter Positioning and Ablation in Cardiac Electrophysiology Procedures
Published on: April 21, 2013
Initial clinical experience with cardiac resynchronization therapy utilizing a magnetic navigation system
Peter Gallagher1, Laura Martin, Lori Angel
1Central Baptist Hospital, Lexington, Kentucky, USA. pgallagher@lexingtoncardio.com
Insights
Magnetic navigation offers a safe and efficient method for left ventricular (LV) lead placement during cardiac resynchronization therapy (CRT). This technique reduces procedure times, especially when targeting multiple coronary sinus branches.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Left ventricular (LV) lead placement in cardiac resynchronization therapy (CRT) presents significant technical challenges.
- These difficulties often lead to extended procedure durations and reduced success rates.
Purpose of the Study:
- To evaluate the safety, feasibility, and efficiency of magnetic navigation for LV lead placement during CRT.
- To compare procedural times using magnetic navigation versus conventional methods.
Main Methods:
- Magnetic navigation with a magnet-tipped guidewire was used in 50 patients undergoing CRT.
- LV leads were placed in lateral coronary sinus (CS) branches using either a standard delivery sheath or a "bare-wire" approach.
- Outcomes were compared to non-magnetic-assisted CRT cases.
Main Results:
- Magnetic navigation reduced total LV lead positioning times compared to non-magnetic-assisted controls (10.4 +/- 7.6 min vs 18.6 +/- 18.9 min).
- The "bare-wire" approach with magnetic navigation was associated with shorter procedure and LV lead positioning times compared to using a delivery sheath.
- Shorter LV lead placement times were observed when magnetic navigation was used, particularly when multiple CS branches were evaluated (16.2 +/- 7.7 min vs 36.4 +/- 23.4 min).
Conclusions:
- Magnetic navigation is a safe, feasible, and efficient tool for lateral LV lead placement in CRT.
- This technology facilitates precise control of guidewire direction.
- Magnetic navigation can decrease LV lead placement times, especially in complex cases involving multiple coronary sinus branches.
Introduction:
The placement of left ventricular (LV) leads during cardiac resynchronization therapy (CRT) involves many technical difficulties. These difficulties increase procedural times and decrease procedural success rates.
Methods And Results:
A total of 50 patients with severe cardiomyopathy (mean LV ejection fraction was 21 +/- 6%) and a wide QRS underwent CRT implantation. Magnetic navigation (Stereotaxis, Inc.) was used to position a magnet-tipped 0.014'' guidewire (Cronus guidewire) within the coronary sinus (CS) vasculature. LV leads were placed in a lateral CS branch, either using a standard CS delivery sheath or using a "bare-wire" approach without a CS delivery sheath. The mean total procedure time was 98.1 +/- 29.1 minutes with a mean fluoroscopy time of 22.7 +/- 15.1 minutes. The mean LV lead positioning time was 10.4 +/- 7.6 minutes. The use of a delivery sheath was associated with longer procedure times 98 +/- 32 minutes vs 80 +/- 18 minutes (P = 0.029), fluoroscopy times 23 +/- 15 minutes vs 13 +/- 4 minutes (P = 0.0007) and LV lead positioning times 10 +/- 6 minutes vs 4 +/- 2 minutes (P = 0.015) when compared to a "bare-wire" approach. When compared with 52 nonmagnetic-assisted control CRT cases, magnetic navigation reduced total LV lead positioning times (10.4 +/- 7.6 minutes vs 18.6 +/- 18.9 minutes; P = 0.005). If more than one CS branch vessel was tested, magnetic navigation was associated with significantly shorter times for LV lead placement (16.2 +/- 7.7 minutes vs 36.4 +/- 23.4 minutes; P = 0.004).
Conclusions:
Magnetic navigation is a safe, feasible, and efficient tool for lateral LV lead placement during CRT. Magnetic navigation during CRT allows for control of the tip direction of the Cronus 0.014'' guidewire using either a standard CS delivery sheath or "bare-wire" approach. Although there are some important limitations to the 0.014'' Cronus magnetic navigation can decrease LV lead placement times compared with nonmagnetic-assisted control CRT cases, particularly if multiple CS branches are to be tested.
