Robotic approach to catheter ablation

Purpose of review The aim of this review is to introduce two novel techniques for catheter ablation of various arrhythmias in a remote-controlled fashion. Recent findings The electromechanical system Sensei consists of two steerable sheaths that navigate conventional catheters via a ‘master-slave’ input device. The magnetic navigation system Niobe consists of two outer permanent magnets that cause a uniform magnetic field in which a specialized magnetically equipped catheter has to align in parallel. Both systems can interact with three-dimensional mapping systems and several reports on the clinical effectiveness of the systems have been published, which will be critically discussed in this review. Summary These two novel technologies offer the fascinating option of performing catheter ablation in a remote-controlled fashion. Future studies and head-to-head comparisons with conventional ablation techniques will prove the impact of remote navigation, which hopefully will remove invasive electrophysiologists away from patients without the risks of reduced efficacy or increased procedural risks.

[1]  L. Jordaens,et al.  Remote magnetic navigation for mapping and ablating right ventricular outflow tract tachycardia. , 2006, Heart rhythm.

[2]  David O. Martin,et al.  Remote magnetic navigation: human experience in pulmonary vein ablation. , 2007, Journal of the American College of Cardiology.

[3]  SabineErnst,et al.  Initial Experience With Remote Catheter Ablation Using a Novel Magnetic Navigation System , 2004 .

[4]  V. Santinelli,et al.  Robotic magnetic navigation for atrial fibrillation ablation. , 2006, Journal of the American College of Cardiology.

[5]  B. Lindsay,et al.  Novel, Magnetically Guided Catheter for Endocardial Mapping and Radiofrequency Catheter Ablation , 2002, Circulation.

[6]  B. Lindsay,et al.  Radiofrequency ablation of atrioventricular nodal reentrant tachycardia using a novel magnetic guidance system compared with a conventional approach. , 2006, Heart rhythm.

[7]  W. Saliba,et al.  Novel Robotic Catheter Remote Control System: Feasibility and Safety of Transseptal Puncture and Endocardial Catheter Navigation , 2006, Journal of cardiovascular electrophysiology.

[8]  Sabine Ernst,et al.  Modulation of the slow pathway in the presence of a persistent left superior caval vein using the novel magnetic navigation system Niobe. , 2004, Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology.

[9]  S. Ernst,et al.  Initial Experience With Remote Catheter Ablation Using a Novel Magnetic Navigation System: Magnetic Remote Catheter Ablation , 2004, Circulation.

[10]  S. Ernst,et al.  Remote-controlled catheter ablation of accessory pathways: results from the magnetic laboratory. , 2006, European heart journal.

[11]  Sabine Ernst,et al.  Remote Catheter Ablation of Parahisian Accessory Pathways Using a Novel Magnetic Navigation System—A Report of Two Cases , 2005, Journal of cardiovascular electrophysiology.

[12]  Sabine Ernst,et al.  Remote-controlled magnetic ablation of a right anterolateral accessory pathway—The superior caval vein approach , 2006, Journal of Interventional Cardiac Electrophysiology.

[13]  R. Cury,et al.  View-Synchronized Robotic Image-Guided Therapy for Atrial Fibrillation Ablation: Experimental Validation and Clinical Feasibility , 2007, Circulation.

[14]  Paul J. Wang,et al.  Early Experience with a Computerized Robotically Controlled Catheter System , 2005, Journal of Interventional Cardiac Electrophysiology.

[15]  Michael Talcott,et al.  Magnetic guidance system for cardiac electrophysiology: a prospective trial of safety and efficacy in humans. , 2003, Journal of the American College of Cardiology.

[16]  Vivek Y. Reddy,et al.  Remote Magnetic Navigation to Guide Endocardial and Epicardial Catheter Mapping of Scar-Related Ventricular Tachycardia , 2007, Circulation.

[17]  W. Saliba,et al.  Remote Magnetic Navigation to Map and Ablate Left Coronary Cusp Ventricular Tachycardia , 2006, Journal of cardiovascular electrophysiology.

[18]  L. Jordaens,et al.  Use of Advanced Mapping and Remote Magnetic Navigation to Ablate Left Ventricular Fascicular Tachycardia , 2006, Pacing and clinical electrophysiology : PACE.

[19]  B. Lüderitz,et al.  Cerebral Diffusion‐Weighted Magnetic Resonance Imaging: A Tool to Monitor the Thrombogenicity of Left Atrial Catheter Ablation , 2005, Journal of cardiovascular electrophysiology.