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阵发性和持续性心房颤动导管消融的机器人导航初步经验。

Initial experience with robotic navigation for catheter ablation of paroxysmal and persistent atrial fibrillation.

作者信息

Thomas Dierk, Scholz Eberhard P, Schweizer Patrick A, Katus Hugo A, Becker Rüdiger

机构信息

Department of Cardiology, Medical University Hospital Heidelberg, Heidelberg, Germany.

出版信息

J Electrocardiol. 2012 Mar;45(2):95-101. doi: 10.1016/j.jelectrocard.2011.05.005. Epub 2011 Jun 28.

Abstract

BACKGROUND AND PURPOSE

Remote robotic navigation (RRN) technology has been developed to facilitate catheter ablation of symptomatic atrial fibrillation (AF). Here, we assess procedural parameters of AF ablation obtained during initial use of RRN compared with a control group treated with a manual ablation approach.

METHODS

Consecutive patients with symptomatic paroxysmal or persistent AF were subjected to radiofrequency catheter ablation with RRN (Sensei X [Hansen Medical, Mountain View, CA]; n = 25; mean age, 60 ± 2.3 years) or using the standard manual technique (n = 61; mean age, 62 ± 1.4 years). A circumferential pulmonary vein isolation approach guided by 3-dimensional electroanatomical mapping was followed.

RESULTS

Remote robotic navigation was associated with reduction of overall fluoroscopy time by 26%. In a case-control subgroup analysis comparing 25 patients with similar clinical characteristics from each group, mean fluoroscopy time was reduced by 22%. Acute isolation of pulmonary veins was achieved in 97% (RRN) and 96% (conventional ablation), respectively. Ablation times and frequency of adverse events were not significantly different among study groups.

CONCLUSIONS

The early use of RRN resulted in a significant reduction of overall fluoroscopy time and was equally effective and safe compared with manual catheter ablation.

摘要

背景与目的

已开发出远程机器人导航(RRN)技术以促进有症状心房颤动(AF)的导管消融。在此,我们评估在首次使用RRN期间获得的AF消融程序参数,并与采用手动消融方法治疗的对照组进行比较。

方法

连续有症状的阵发性或持续性AF患者接受使用RRN(Sensei X [汉森医疗公司,加利福尼亚州山景城];n = 25;平均年龄,60±2.3岁)或使用标准手动技术(n = 61;平均年龄,62±1.4岁)进行射频导管消融。采用三维电解剖标测引导的环肺静脉隔离方法。

结果

远程机器人导航使总体透视时间减少了26%。在一项病例对照亚组分析中,比较每组25例具有相似临床特征的患者,平均透视时间减少了22%。肺静脉急性隔离率分别为97%(RRN)和96%(传统消融)。研究组之间的消融时间和不良事件发生率无显著差异。

结论

早期使用RRN可显著减少总体透视时间,与手动导管消融相比同样有效且安全。

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