Matsuo, S., Yamane, T., Tokuda, M., Date. T., Hioki, M., Narui, R., … Yoshimura, M. (2012). Europace, 12(3), 402-9.

The use of a steerable sheath reduced the time and amount of energy needed to achieve a bidirectional conduction block in the cavotricuspid isthmus (CTI). For patients in whom the establishment of a conduction block is difficult, a steerable sheath should be considered as a therapeutic option for typical atrial flutter (AFL) ablation.

Masuda, M., Fujita, M., Iida, O., Okamoto, S., Ishihara, T., Nanto, K., . . . Uematsu, M. (2016). Journal of Interventional Cardiac Electrophysiology, 47(1), 99-107.

The beneficial effects of using steerable sheaths were more prominent in patients with severe left atrial (LA) enlargement.

Piorkowski, C., Eite, C., Rolf, S., Bode, K., Sommer, P., Gaspar, T., … Hindricks, G.(2011). Circulation, 4(2), 157-65.

Atrial fibrillation (AF) catheter ablation using a manually controlled, steerable sheath for catheter navigation resulted in a significantly higher clinical success rate, with comparable complication rates and with a reduction in periprocedural fluoroscopy time.

Piorkowski, C., Kottkamp, H., Gerds-Li, J. H., Arya, A., Sommer, P., Dagres, N., Hindricks, G. (2008). Pacing and Clinical Electrophysiology, 31(7), 863-873.

An AF mapping and ablation approach solely using a manually controlled steerable sheath for catheter navigation improved the outcome of circumferential left atrial pulmonary vein (PV) ablation at similar intervention times and similar complication rates. The 6‐month success rate after a single LA intervention increased from 56% to 77%.

Kimura, T., Takatsuki, S., Oishi, A., Negishi, M., Kashimura, S., Katsumata, Y., . . . Fukuda, K. (2014). International Journal of Cardiology, 177(3), 970-976.

Contact force (CF) or PV isolation was significantly different depending on the position of the catheter and the type of sheath.