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Reduced Fluoroscopy During Atrial Fibrillation Ablation: Benefits of Robotic Guided Navigation
Author(s) -
STEVEN DANIEL,
SERVATIUS HELGE,
ROSTOCK THOMAS,
HOFFMANN BORIS,
DREWITZ IMKE,
MÜLLERLEILE KAI,
SULTAN ARIAN,
AYDIN MUHAMMET ALI,
MEINERTZ THOMAS,
WILLEMS STEPHAN
Publication year - 2010
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.1540-8167.2009.01592.x
Subject(s) - fluoroscopy , medicine , atrial fibrillation , ablation , pulmonary vein , catheter ablation , randomized controlled trial , catheter , ablation of atrial fibrillation , cardiology , nuclear medicine , radiology
Reduced Fluoroscopy in PVI Using RN. Background: Recently, a nonmagnetic robotic navigation system (RN, Hansen‐Sensei™) has been introduced for remote catheter manipulation. Objective: To investigate the influence of RN combined with intuitive 3‐dimensional mapping on the fluoroscopy exposure to operator and patient during pulmonary vein isolation (PVI) for paroxysmal atrial fibrillation (PAF) in a prospective randomized trial. Methods: Sixty patients were randomly assigned to undergo PVI either using a RN guided (group 1; n = 30, 20 male, 62 ± 7.7 years) or conventional ablation approach (group 2; n = 30, 14 male, 61 ± 7.6 years). A 3‐dimensional mapping system (NavX™) was used in both groups. Results: Electrical disconnection of the ipsilateral pulmonary veins (PVs) was achieved in all patients. Use of RN significantly lowered the overall fluoroscopy time (9 ± 3.4 vs 22 ± 6.5 minutes; P < 0.001) and reduced the operator's fluoroscopy exposure (7 ± 2.1 vs 22 ± 6.5 minutes; P < 0.001). The difference in fluoroscopy duration between both groups was most pronounced during the ablation part of the procedure (3 ± 2.4 vs 17 ± 6.3 minutes; P < 0.001). The overall procedure duration tended to be prolonged using RN without reaching statistical significance (156 ± 44.4 vs 134 ± 12 minutes, P = 0.099). No difference regarding outcome was found during a midterm follow‐up of 6 months (AF freedom group 1 = 73% vs 77% in group 2 [P = 0.345]). Conclusion: The use of RN for PVI seems to be effective and significantly reduces overall fluoroscopy time and operator's fluoroscopy exposure without affecting mid‐term outcome after 6‐month follow‐up. (J Cardiovasc Electrophysiol, Vol. 21, pp. 6–12, January 2010)