Robotic Ablation of Atrial Fibrillation Saves Time and Irradiation Dose
Samir Rafla, Mostafa Nawar, Amr Kamal, Josef Kautzner
Correspondence Address :
of Cardiology and Angiology
IKEM institute, Prague, Czech Republic
Received on: November 28, 2017, Accepted on: December 06, 2017, Published on: December 13, 2017
Citation: Samir Rafla, Mostafa Nawar, Amr Kamal, Josef Kautzner (2017). Robotic Ablation of Atrial Fibrillation Saves Time and Irradiation Dose
Copyright: 2017 Samir Rafla, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
This analysis assesses the effect of Robotic technique on the results of ablation of paroxysmal AF.
Methods: We studied 150 patients (pts) (86 males and 64 females) having a mean age of 51.3 yrs (54 > 50, 96 below 50 yrs), who suffered from symptomatic drug refractory paroxysmal AF. Work was done in IKEM hospital in Prague. Cardiac MSCT image integration to the 3D electroanatomic LA map was used in 106 pts (70.6%, however all of them underwent intracardiac echo guided imaging during the ablation procedure. 40 pts underwent manual RF ablation using CARTO, 40 pts underwent ablation using NavX system, 70 pts underwent robotic ablation using Sensui system. Pulmonary vein isolation was done to all pts using either pulmonary vein (PV) antral isolation in 116 (77.3%) or circumferential pulmonary vein ablation in 34 pts (22.7%). All pts were followed at 3, 6, 9, and 12 months.
Results: Procedural time was significantly longer in manual (202.0 +/- 19.4 minutes) compared to Robot group (146.4 +/- 10.8 minutes). Total fluoroscopy time was significantly shorter in Robot group (6.9 +/- 1.9 minutes) compared to non-robotic group (19.9 +/- 3.1 minutes). The mean fluoroscopy dose area-product was significantly lower in Robot group (552.7 +/- 194.1 μ Gy.cm2) compared to manual group (2257.2 +/- 568.1 μGy.cm2).
Conclusions: The robotic group showed evident and clear benefit of the use of robotic navigation system in the form of much shorter total procedure time, shorter total fluoroscopy time and fluoroscopy exposure dose with less number of ablation points.
Keywords: Atrial fibrillation, Ablation techniques, Pulmonary vein isolation, Robotic ablation procedures, Radiation, Administration and dosage