Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, Texas, USA.
J Cardiovasc Electrophysiol. 2009 Dec;20(12):1328-35. doi: 10.1111/j.1540-8167.2009.01570.x.
Robotic catheter navigation and ablation either with magnetic catheter driving or with electromechanical guidance have emerged in the recent years for the treatment of atrial fibrillation.
The aim of this study was to compare our center's experience of atrial fibrillation ablation using the Hansen Robotic Medical System with our current manual ablation technique in terms of acute and chronic success, as well as procedure time and radiation exposure to both the patient and the operator.
A total of 390 consecutive patients with symptomatic and drug-resistant atrial fibrillation (289 males, 62 +/- 11 years) were prospectively enrolled in the study. All patients underwent the procedure either with conventional manual ablation (group 1, n = 197) or with the robotic navigation system (RNS) (group 2, n = 193).
The success rate for RNS was 85% (164 patients), while for manual ablation it was 81% (159 patients) (p = 0.264) at 14.1 +/- 1.3 months with AADs previously ineffective. Fluoroscopy time was significantly lower for RNS (48.9 +/- 24.6 minutes for RNS vs. 58.4 +/- 20.1 minutes for manual ablation, P < 0.001). Mean fluoroscopy time was statistically reduced after 50 procedures (61.8 +/- 23.2 minutes for first 50 cases vs. 44.5 +/- 23.6 minutes for subsequent procedures, P < 0.0001).
Robotic navigation and ablation of atrial fibrillation is safe and effective. Fluoroscopy time decreases with experience.
近年来，出现了使用磁导管驱动或机电引导的机器人导管导航和消融技术，用于治疗心房颤动。
本研究旨在比较我们中心使用 Hansen 机器人医疗系统进行心房颤动消融的经验与我们目前的手动消融技术在急性和慢性成功率方面的差异，以及手术时间和患者及术者的辐射暴露。
共前瞻性纳入 390 例有症状且药物难治性心房颤动患者（289 例男性，62±11 岁）。所有患者均接受常规手动消融（组 1，n=197）或机器人导航系统（RNS）消融（组 2，n=193）。
RNS 的成功率为 85%（164 例），而手动消融的成功率为 81%（159 例）（p=0.264），在使用之前无效的抗心律失常药物后 14.1±1.3 个月。RNS 的透视时间明显更短（RNS 为 48.9±24.6 分钟，手动消融为 58.4±20.1 分钟，P<0.001）。在进行 50 例手术之后，平均透视时间呈统计学降低（前 50 例为 61.8±23.2 分钟，后 50 例为 44.5±23.6 分钟，P<0.0001）。
机器人导航和消融心房颤动是安全有效的。透视时间随经验的增加而减少。
