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Robotically Assisted Ablation Produces More Rapid and Greater Signal Attenuation Than Manual Ablation
Author(s) -
KOAWING MICHAEL,
KOJODJOJO PIPIN,
MALCOLMELAWES LOUISA C.,
SALUKHE TUSHAR V.,
LINTON NICK W.F.,
GROGAN AARON P.,
BERGMAN DALE,
LIM PHANG BOON,
WHINNETT ZACHARY I.,
McCARTHY KAREN,
HO SIEW YEN,
O’NEILL MARK D.,
PETERS NICHOLAS S.,
DAVIES D. WYN,
KANAGARATNAM PRAPA
Publication year - 2009
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2009.01590.x
Subject(s) - ablation , medicine , catheter ablation , catheter , signal (programming language) , biomedical engineering , atrial fibrillation , nuclear medicine , surgery , cardiology , computer science , programming language
Robotic remote catheter ablation potentially provides improved catheter‐tip stability, which should improve the efficiency of radiofrequency energy delivery. Percentage reduction in electrogram peak‐to‐peak voltage has been used as a measure of effectiveness of ablation. We tested the hypothesis that improved catheter‐tip stability of robotic ablation can diminish signals to a greater degree than manual ablation.Methods:In vivo NavX™ maps of 7 pig atria were constructed. Separate lines of ablation were performed robotically and manually, recording pre‐ and postablation peak‐to‐peak voltages at 10, 20, 30, and 60 seconds and calculating signal amplitude reduction. Catheter ablation settings were constant (25W, 50°, 17 mL/min, 20–30 g catheter tip pressure). The pigs were sacrificed and ablation lesions correlated with NavX maps.Results:Robotic ablation reduced signal amplitude to a greater degree than manual ablation (49 ± 2.6% vs 29 ± 4.5% signal reduction after 1 minute [P = 0.0002]). The mean energy delivered (223 ± 184 J vs 231 ± 190 J, P = 0.42), power (19 ± 3.5 W vs 19 ± 4 W, P = 0.84), and duration of ablation (15 ± 9 seconds vs 15 ± 9 seconds, P = 0.89) was the same for manual and robotic. The mean peak catheter‐tip temperature was higher for robotic (45 ± 5°C vs 42 ± 3°C [P < 0.0001]). The incidence of >50% signal reduction was greater for robotic (37%) than manual (21%) ablation (P = 0.0001).Conclusion:Robotically assisted ablation appears to be more effective than manual ablation at signal amplitude reduction, therefore may be expected to produce improved clinical outcomes.