Accurate and Reproducible Target Navigation with the Stereotaxis Niobe® Magnetic Navigation System

Introduction: The Stereotaxis Niobe® Magnetic Navigation System (MNS, Stereotaxis, Inc., St. Louis, MO, USA) allows for remote-control navigation of magnetically enabled catheters and guidewires for clinical ablation and electrophysiology (EP) device placement using two permanent magnets located on opposite sides of the patient table. Our objective was to provide a clinical framework for expected navigational accuracy during a case by calibrating the system's reproducibility using a realistic heart phantom under various conditions. Methods and Results: We performed two sets of experiments to demonstrate the accuracy of magnetic catheters using the MNS. The first experiment calibrated deviations in the deflection of an EP catheter by the magnetic system from the expected angles using proprietary algorithms based on predicted geometry. We found that the magnetic fields produced catheter angulation movements within a mean of 4° of biophysical predictions. The second experiment used the MNS to navigate these catheters to previously labeled target positions within a phantom heart model and estimated the actual displacement from desired target positions. We found that the accuracy for reaching the desired targets was 100%. Conclusions: Remote navigation of magnetically enabled EP catheters using the MNS accurately and reproducibly navigates to target sites in a heart phantom. This may enable more complex, successful, and time-efficient procedures in the cardiac catheterization laboratory.