Atrial Fibrillation Ablation Using a Robotic Catheter Remote Control System. Initial Human Experience and Long-Term Follow-Up Results

Walid Saliba, Vivek Y. Reddy, Oussama Wazni, Jennifer E. Cummings, J. David Burkhardt, Michel Haissaguerre, Josef Kautzner, Petr Peichl, Petr Neuzil, Volker Schibgilla, Georg Noelker, Johannes Brachmann, Luigi Di Biase, Conor Barrett, Pierre Jais, Andrea Natale

Research output: Contribution to journalArticle

187 Citations (Scopus)

Abstract

Objectives: We present the initial clinical human experience with the use of a robotic remote navigation system (Hansen Medical, Mountain View, California), to perform left and right atrial mapping and radiofrequency ablation of atrial fibrillation (AF) and atrial flutter (AFL). Background: Catheter ablation is an established curative modality for various arrhythmias. A robotic steerable sheath system (SSS) (Hansen Medical) allows better catheter stability and greater degrees of freedom of catheter movement. Methods: A total of 40 patients (mean age 57 years) with antiarrhythmic drug (AAD)-refractory AF (23 had also concomitant documented typical AFL) were studied. Three-dimensional reconstruction of the corresponding atrial chamber anatomy was performed with the CARTO electroanatomic mapping system (Biosense Webster, Diamond Bar, California or the EnSite NavX system (St. Jude Medical, Minneapolis, Minnesota) in combination with the Artisan catheter (Hansen Medical). In patients undergoing AF ablation, 2 transseptal punctures were performed under intracardiac ultrasound (ICE) guidance, with one of the punctures being performed using SSS. Pulmonary vein antrum isolation was performed with a 3.5-mm thermocool catheter manipulated with the use of the SSS and was verified by circular mapping. Patients were followed clinically for recurrence of arrhythmia with an event transmitter and ambulatory holter monitoring. Clinical recurrence of AF/AFL was defined as AF/AFL episodes >1 min in duration. Results: Pulmonary vein antrum isolation was performed in 40 patients, including 23 with concomitant typical AFL ablation. All pulmonary veins, including the superior vena cava, were successfully isolated. In 23 of 40 patients, cavotricuspid ablation was also performed with bidirectional block obtained. At 1-year follow-up, 34 patients (86%) and 5 patients were free from atrial arrhythmia off AADs and on AADs, respectively. Conclusions: This preliminary human experience suggests that mapping and ablation of AFL and AF using this novel robotic catheter with remote control system is feasible with similar results to conventional approach.

Original languageEnglish (US)
Pages (from-to)2407-2411
Number of pages5
JournalJournal of the American College of Cardiology
Volume51
Issue number25
DOIs
StatePublished - Jun 24 2008
Externally publishedYes

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Robotics
Atrial Flutter
Atrial Fibrillation
Catheters
Pulmonary Veins
Cardiac Arrhythmias
Punctures
Ambulatory Monitoring
Recurrence
Ambulatory Electrocardiography
Diamond
Superior Vena Cava
Catheter Ablation
Anti-Arrhythmia Agents
Anatomy

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Atrial Fibrillation Ablation Using a Robotic Catheter Remote Control System. Initial Human Experience and Long-Term Follow-Up Results. / Saliba, Walid; Reddy, Vivek Y.; Wazni, Oussama; Cummings, Jennifer E.; Burkhardt, J. David; Haissaguerre, Michel; Kautzner, Josef; Peichl, Petr; Neuzil, Petr; Schibgilla, Volker; Noelker, Georg; Brachmann, Johannes; Di Biase, Luigi; Barrett, Conor; Jais, Pierre; Natale, Andrea.

In: Journal of the American College of Cardiology, Vol. 51, No. 25, 24.06.2008, p. 2407-2411.

Research output: Contribution to journalArticle

Saliba, W, Reddy, VY, Wazni, O, Cummings, JE, Burkhardt, JD, Haissaguerre, M, Kautzner, J, Peichl, P, Neuzil, P, Schibgilla, V, Noelker, G, Brachmann, J, Di Biase, L, Barrett, C, Jais, P & Natale, A 2008, 'Atrial Fibrillation Ablation Using a Robotic Catheter Remote Control System. Initial Human Experience and Long-Term Follow-Up Results', Journal of the American College of Cardiology, vol. 51, no. 25, pp. 2407-2411. https://doi.org/10.1016/j.jacc.2008.03.027
Saliba, Walid ; Reddy, Vivek Y. ; Wazni, Oussama ; Cummings, Jennifer E. ; Burkhardt, J. David ; Haissaguerre, Michel ; Kautzner, Josef ; Peichl, Petr ; Neuzil, Petr ; Schibgilla, Volker ; Noelker, Georg ; Brachmann, Johannes ; Di Biase, Luigi ; Barrett, Conor ; Jais, Pierre ; Natale, Andrea. / Atrial Fibrillation Ablation Using a Robotic Catheter Remote Control System. Initial Human Experience and Long-Term Follow-Up Results. In: Journal of the American College of Cardiology. 2008 ; Vol. 51, No. 25. pp. 2407-2411.
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AU - Saliba, Walid

AU - Reddy, Vivek Y.

AU - Wazni, Oussama

AU - Cummings, Jennifer E.

AU - Burkhardt, J. David

AU - Haissaguerre, Michel

AU - Kautzner, Josef

AU - Peichl, Petr

AU - Neuzil, Petr

AU - Schibgilla, Volker

AU - Noelker, Georg

AU - Brachmann, Johannes

AU - Di Biase, Luigi

AU - Barrett, Conor

AU - Jais, Pierre

AU - Natale, Andrea

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N2 - Objectives: We present the initial clinical human experience with the use of a robotic remote navigation system (Hansen Medical, Mountain View, California), to perform left and right atrial mapping and radiofrequency ablation of atrial fibrillation (AF) and atrial flutter (AFL). Background: Catheter ablation is an established curative modality for various arrhythmias. A robotic steerable sheath system (SSS) (Hansen Medical) allows better catheter stability and greater degrees of freedom of catheter movement. Methods: A total of 40 patients (mean age 57 years) with antiarrhythmic drug (AAD)-refractory AF (23 had also concomitant documented typical AFL) were studied. Three-dimensional reconstruction of the corresponding atrial chamber anatomy was performed with the CARTO electroanatomic mapping system (Biosense Webster, Diamond Bar, California or the EnSite NavX system (St. Jude Medical, Minneapolis, Minnesota) in combination with the Artisan catheter (Hansen Medical). In patients undergoing AF ablation, 2 transseptal punctures were performed under intracardiac ultrasound (ICE) guidance, with one of the punctures being performed using SSS. Pulmonary vein antrum isolation was performed with a 3.5-mm thermocool catheter manipulated with the use of the SSS and was verified by circular mapping. Patients were followed clinically for recurrence of arrhythmia with an event transmitter and ambulatory holter monitoring. Clinical recurrence of AF/AFL was defined as AF/AFL episodes >1 min in duration. Results: Pulmonary vein antrum isolation was performed in 40 patients, including 23 with concomitant typical AFL ablation. All pulmonary veins, including the superior vena cava, were successfully isolated. In 23 of 40 patients, cavotricuspid ablation was also performed with bidirectional block obtained. At 1-year follow-up, 34 patients (86%) and 5 patients were free from atrial arrhythmia off AADs and on AADs, respectively. Conclusions: This preliminary human experience suggests that mapping and ablation of AFL and AF using this novel robotic catheter with remote control system is feasible with similar results to conventional approach.

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