Disclosure: Dr. Rajappan received speaker's fees from Hansen Medical.
Mitral Isthmus Ablation is Feasible, Efficacious, and Safe Using a Remote Robotic Catheter System
Version of Record online: 10 JUN 2013
©2013, The Authors. Journal compilation ©2013 Wiley Periodicals, Inc.
Pacing and Clinical Electrophysiology
Volume 36, Issue 11, pages 1364–1372, November 2013
How to Cite
WONG, K. C.K., JONES, M., WEBB, T., QURESHI, N., BASHIR, Y., BETTS, T. R. and RAJAPPAN, K. (2013), Mitral Isthmus Ablation is Feasible, Efficacious, and Safe Using a Remote Robotic Catheter System. Pacing and Clinical Electrophysiology, 36: 1364–1372. doi: 10.1111/pace.12201
- Issue online: 24 OCT 2013
- Version of Record online: 10 JUN 2013
- Manuscript Accepted: 23 APR 2013
- Manuscript Revised: 21 APR 2013
- Manuscript Received: 28 SEP 2012
- robotic catheter system;
- radiofrequency ablation;
- atrial fibrillation;
- mitral isthmus
There are limited data on the use of a remote robotic catheter system (RCS) for mitral isthmus (MI) ablation.
This single-center, prospective, matched control study included 45 patients who underwent atrial fibrillation ablation using a remote RCS compared to 45 patients who underwent conventional ablation. All patients had circumferential pulmonary vein isolation (PVI), roof, and MI ablation.
There were no significant differences in baseline clinical characteristics. There were no significant differences in MI block (RCS: 44/45 [98%] vs Control: 43/45 [96%], P = 1.0), roof block (RCS: 45/45 [100%] vs Control: 44/45 [98%], P = 1.0), and PVI (RCS: 45/45 [100%] vs Control: 45/45 [100%], P = 1.0). Ablation and procedural times were similar in both arms. Using RCS, mean total MI ablation and procedure times were 13 ± 6 minutes and 23 ± 15 minutes, respectively. Coronary sinus (CS) ablation was significantly less in the RCS arm (48% vs 72%, P = 0.03). It was possible to “drive” the ablation catheter into the distal CS using the RCS in 19/22 (86%) patients. There was a significant trend of reduction in mean MI ablation (P = 0.008) and procedural times (P = 0.004) over the course of the study period. There was a significant reduction in fluoroscopy time in the RNS arm (33 ± 17 minutes vs 49 ± 20 minutes, P = 0.0004).
It is feasible and safe to use a remote RCS for MI ablation, including “driving into the CS.” MI block was achieved in 98% with a significant reduction in the need for CS ablation (48%). There is a short learning curve.