Published Online
on February 13, 2009

A more recent version of this article appeared on April 1, 2009

This Article Full Text (PDF) All Versions of this Article: 2/2/120    most recent CIRCEP.108.818211v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Schmidt, B. Articles by Ouyang, F. Search for Related Content PubMed PubMed Citation Articles by Schmidt, B. Articles by Ouyang, F. Related Collections Arrhythmias, clinical electrophysiology, drugs Ablation/ICD/surgery Related Article

Original Article

Remote Robotic Navigation and Electroanatomical Mapping for Ablation of Atrial Fibrillation — Considerations for Navigation and Impact on Procedural Outcome

Boris Schmidt¹; Roland R. Tilz; Kars Neven; Julian K.R. Chun; Alexander Fuernkranz and Feifan Ouyang

Asklepios Klinik St. Georg

¹ E-mail: bor.schmidt{at}asklepios.com

Background—Radiofrequency current (RFC) ablation of atrial fibrillation (AF) requires high technical skills to achieve optimal catheter stability and is associated with an individually high X-ray exposure to both the patient and the operator. In order to facilitate catheter navigation and to reduce the operator's X-ray burden remote navigation (RN) systems have been developed. Considerations for navigation of a novel remote robotic navigation system in pulmonary vein isolation (PVI) procedures are reported.

Methods and Results—In 65 patients with drug-refractory AF (43 paroxysmal, 22 persistent) complete circumferential PVI was performed using RN in conjunction with different electroanatomic mapping systems.<br> Acute complete PVI using exclusively RN was achieved in 95%. The procedure time was 195±40 min. The operator's X-ray exposure time was reduced by 6±4 min (35%) using RN. In 7/14 pts with persistent AF conversion to SR was achieved by RFC ablation. During a median follow-up period of 239 days (range 184-314 days) 47/65 patients (73%) remained free of any documented atrial tachyarrhythmia recurrences following a single procedure. The relative proportion of patients remaining free of AF was 76% and 68% for paroxysmal and persistent AF, respectively.

Conclusions—PVI using the novel RN system can be performed safely and effectively. One third of the operator's fluoroscopy exposure time might be saved using RN. However, the question, whether the overall fluoroscopy exposure is reduced by RN and if RN improves PVI procedures needs to be assessed during a comparative trial between man and machine.

Key Words: ablation • fibrillation • mapping • pulmonary vein isolation • remote robotic navigation

Author contributions: Boris Schmidt and Roland R. Tilz contributed equally to the study and the manuscript.

Related Article

Remote Robotic Navigation and Electroanatomical Mapping for Ablation of Atrial Fibrillation: Considerations for Navigation and Impact on Procedural Outcome

Boris Schmidt, Roland R. Tilz, Kars Neven, K.R. Julian Chun, Alexander Fürnkranz, and Feifan Ouyang
Circ Arrhythm Electrophysiol 2009 2: 120-128. [Abstract] [Full Text] [PDF]