Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2016 Feb;105(2):106-16.
doi: 10.1007/s00392-015-0892-6. Epub 2015 Jul 22.

Experience matters: long-term results of pulmonary vein isolation using a robotic navigation system for the treatment of paroxysmal atrial fibrillation

Andreas Rillig  1 , Tina Lin  2 , Boris Schmidt  2 , Britta Feige  2 , Christian Heeger  2 , Jascha Wegner  2 , Erik Wissner  2 , Andreas Metzner  2 , Anita Arya  2 , Shibu Mathew  2 , Peter Wohlmuth  3 , Feifan Ouyang  2 , Karl-Heinz Kuck  2 , Roland Richard Tilz  2
Affiliations
Comparative Study

Experience matters: long-term results of pulmonary vein isolation using a robotic navigation system for the treatment of paroxysmal atrial fibrillation

Andreas Rillig et al. Clin Res Cardiol. 2016 Feb.

Abstract

Background: Long-term results after circumferential pulmonary vein isolation (CPVI) for the treatment of paroxysmal atrial fibrillation (PAF) using a robotic navigation system (RNS) have not yet been reported.

Objective: To evaluate long-term results of patients with PAF after CPVI using RNS.

Methods: In this study, 200 patients (n = 151 (75.5%) male; median age 62.2 (54.7-67.7) years) with PAF were evaluated. In 100 patients, RNS (RN-group) was used for CPVI and compared to 100 manually ablated control patients (MN-group). Radiofrequency was used in conjunction with 3D electroanatomic mapping. Power was limited to 30 watts (W) at the posterior left atrial (LA) wall in the first 49 RNS patients (RN-group-a). After esophageal perforation occurred in one RN-group-a patient, maximum power was reduced to 20 W for the subsequent 51 patients (RN-group-b).

Results: After a median follow-up of 2 years, single (77/100 vs 77/100, p = 0.89) and multiple (90/100 vs 93/100, p = 0.29) procedure success rates were comparable between RN-group and MN-group. Single procedure success rate was significantly lower in RN-group-a as compared to RN-group-b (65.3 vs 88.2%, p = 0.047). In RN-group-a patients, procedural times [200 (170-230) vs 152 (132-200) minutes, p < 0.01] and fluoroscopy times [16.6 (12.9-21.6) minutes vs 13.7 (9.5-19) minutes, p = 0.043] were significantly longer compared to RN-group-b patients.

Conclusion: Long-term success rate after CPVI using RNS was comparable to manual ablation. Despite a lower power limit of 20 W at the posterior LA wall, single procedure success rate was higher in RN-group-b as compared to RN-group-a. Procedure time and fluoroscopy time decreased, whilst success rate increased with increasing experience in the RN-group.

Keywords: Catheter ablation; Learning effect; Long-term outcome; Paroxysmal atrial fibrillation; Pulmonary vein isolation; Robotic navigation.

PubMed Disclaimer

References

    1. Circ Arrhythm Electrophysiol. 2012 Feb;5(1):15-21 - PubMed
    1. Europace. 2012 Oct;14(10):1385-413 - PubMed
    1. Europace. 2010 Mar;12 (3):331-6 - PubMed
    1. J Cardiovasc Electrophysiol. 2010 Jan;21(1):6-12 - PubMed
    1. Dtsch Arztebl Int. 2012 Apr;109(16):293-9 - PubMed

Publication types

LinkOut - more resources