Al-Ahmad Amin, Grossman Jessica D, Wang Paul J
Stanford Arrhythmia Service, Stanford University School of Medicine, CA 94305, USA.
J Interv Card Electrophysiol. 2005 Apr;12(3):199-202. doi: 10.1007/s10840-005-0325-y.
Recently, the use of robotic assisted surgery has been utilized in cardiac surgical procedures. The use of robotics may offer benefits in precision, stability and control of instruments remotely. We report early experience with a novel remote robotic catheter control system (CCS).
We used a computerized robotically controlled catheter system that enables the user to remotely manipulate the tip of a catheter precisely in three dimensions. We tested the robotic catheter control systems ability to navigate within the heart and to make precise, rapid and repeatable movements. We compared the CCS with the ability of a standard quadripolar steerable ablation catheter placed in a deflectable sheath to navigate and make precision movements. Twelve ex-vivo porcine hearts were utilized to permit accurate measurements of navigation and precision. Eight targets were selected for navigation and precision testing. Time was measured for the catheter to reach the predefined target from a specific starting point to test navigation. In addition, time was measured to contact a discrete 0.8 mm target in order to test precision.
The use of the CCS reduced the time needed for both navigation (8.5 +/- 13.9 sec vs. 22.7 +/- 26.7 sec, p = 0.002) and significantly decreased the time for precision targeting (10.1 +/- 6.9 sec vs. 29.6 +/- 26.4 sec, p < 0.001) in the specific RA and LA sites in the ex-vivo hearts.
The use of a computerized robotically assisted catheter control system is feasible and shows promise in rapid precision movement of the catheter. Further study is needed to elucidate the role of such a system in-vivo and in patient specific catheter ablation and mapping.
最近,机器人辅助手术已应用于心脏外科手术。机器人的使用可能在器械的精确性、稳定性和远程控制方面带来益处。我们报告了一种新型远程机器人导管控制系统(CCS)的早期经验。
我们使用了一种计算机控制的机器人导管系统,该系统能让使用者在三维空间中精确地远程操控导管尖端。我们测试了机器人导管控制系统在心脏内导航以及进行精确、快速和可重复运动的能力。我们将CCS与置于可弯曲鞘管中的标准四极可控消融导管的导航和精确运动能力进行了比较。使用了12个离体猪心来准确测量导航和精确性。选择了8个靶点进行导航和精确性测试。测量导管从特定起始点到达预定义靶点的时间以测试导航。此外,测量接触一个离散的0.8毫米靶点的时间以测试精确性。
在离体心脏的特定右心房和左心房部位,使用CCS减少了导航所需时间(8.5±13.9秒对22.7±26.7秒,p = 0.002),并显著缩短了精确靶向所需时间(10.1±6.9秒对29.6±26.4秒,p < 0.001)。
使用计算机辅助机器人导管控制系统是可行的,并且在导管的快速精确运动方面显示出前景。需要进一步研究以阐明这种系统在体内以及患者特异性导管消融和标测中的作用。