Abstract
Background: Robotic (RNS) or magnetic navigation systems (MNS) are available for remotely performed catheter ablation for atrial fibrillation (AF). Objective: The present study compares remotely assisted catheter navigation (RAN) to standard manual navigation (SMN) and both systems amongst each other. Methods: The analysis is based on a sub-cohort enrolled by five hospitals from the multicenter German ablation Registry. Results: Out of 2442 patients receiving catheter ablation of AF, 267 (age 61.4 ± 10.4, 69.7% male) were treated using RAN (RNS n = 187, 7.7% vs. MNS n = 80, 3.3%). Fluoroscopy time [RNS median 17 (IQR 12–25) min vs. MNS 22 (16–32) min; p < 0.001] and procedure duration [RNS 180 (145–220) min vs. MNS 265 (210–305) min; p < 0.001] were significantly different. Comparing RAN (11%) to SMN (89%) fluoroscopy time (RAN 19 (13–27) min, vs. SMN 25 (16–40) min; p < 0.001), energy delivery (RAN 3168 (2280–3840) s vs. SMN 2640 (IQR 1799–3900) s; p = 0.008) and procedure duration [RAN 195 (150–255) min vs. SMN 150 (120–150) min; p = 0.001] differed significantly. In terms of acute and 12 months outcome, no differences were seen between the two systems or in comparison to SMN. Conclusion: AF ablation can be performed safely, with high acute success rates using RAN. RNS results in less fluoroscopy burden and shorter procedure durations. Compared to SMN, a reduced fluoroscopy burden, prolonged procedure and ablation duration were observed using RAN. Overall, the number of RAN procedures is small suggesting low impact on clinical routine of AF ablation.
| Original language | English |
|---|---|
| Journal | Clinical Research in Cardiology |
| Volume | 108 |
| Issue number | 3 |
| Pages (from-to) | 298-308 |
| Number of pages | 11 |
| ISSN | 1861-0684 |
| DOIs | |
| Publication status | Published - 01.03.2019 |
Funding
The Foundation Institut für Herzinfarktforschung (IHF, Ludwigshafen, Germany) as the central contract research organization for this study was responsible for project management, data management and clinical monitoring. The respective physician or study nurse in the participating center performed the data acquisition of patient characteristics, procedural data and complication monitoring. Documentation and data management was handled paperless as an internet-based case report form system; all obtained information was confidential and the transmitted data from the participating center was encrypted with a secure socket layer. The final data management, description of the biometric model and statistical analysis was carried out by the IHF [22].