ArticleClinical research in cardiology : official journal of the German Cardiac Society2013
Left atrial isthmus line ablation using a remote robotic navigation system: feasibility, efficacy and long-term outcome.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 14 citations in OpenAlex.
- Review
- Experience matters: long-term results of pulmonary vein isolation using a robotic navigation system for the treatment of paroxysmal atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Comparison of contact force-guided procedure with non-contact force-guided procedure during left atrial mapping and pulmonary vein isolation: impact of contact force on recurrence of atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- Atrial fibrillation and long-term sports practice: epidemiology and mechanisms.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Review
- Remote magnetic navigation for persistent atrial fibrillation ablation via a retrograde aortic access: an approach for patients after atrial septal defect device closure.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
- Percutaneous coil embolization of a perforated side branch of the right coronary artery causing a pericardial tamponade 3 weeks after abdominal surgery.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
- Uncommon delayed and late complications after percutaneous left atrial appendage closure with Amplatzer(®) Cardiac Plug.Clinical research in cardiology : official journal of the German Cardiac Society · 2014Article
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeft atrial isthmus (LAI)-ablation in addition to circumferential pulmonary vein isolation (CPVI) may improve outcomes in select patients with atrial fibrillation (AF). However, bidirectional LAI-block is difficult to obtain. No systematic evaluation reporting on the feasibility and efficacy of LAI-ablation using a robotic navigation system (RNS) exists. METHODS AND
resultsIn this pilot study, CPVI combined with LAI-ablation were performed using a RNS and 3D-mapping system in 42 patients with persistent (n = 24, 57.1 %) or longstanding persistent AF. Ablation was performed using either a 3.5 mm irrigated tip catheter (ITC) with 6 (group-A, n = 16; max. 40 W, contact force 10-40 g) or (after a steam pop occurred in one patient) with a 4 mm ITC with 12 irrigation holes (group-B, n = 26; max. 30 W, contact force 10-30 g). Epicardial ablation was performed manually whenever bidirectional LAI-block could not be obtained with a maximum of 20 endocardial RF-applications. LAI-conduction block was achieved in all patients using RNS; in six patients (14.3 %), additional epicardial ablation was required to achieve LAI-block. A steam pop occurred during LAI-ablation resulting in cardiac tamponade in one patient in group-A. After a median follow-up period of 21 months, arrhythmia recurrence was seen in in 23/42 patients (18 patients with AF and 5 patients with atrial tachycardia) and repeat procedure was performed in 12 (28.6 %) patients; recovered LAI-conduction was found in 5/12 (41.7 %) patients. The RNS-group was compared to a historical group of 20 patients with manual LAI-ablation. Using RNS, LAI-block was more often achieved (42 (100 %) vs 16 (80 %), p < 0.01) and epicardial ablation was required in a significantly smaller number of patients (6 (14.3) vs 10 (50 %), p < 0.01).
conclusionsLAI-ablation using RNS appears to be feasible in all patients. At repeat procedure, LAI-conduction can frequently occur; power and contact-force adaption appears to be mandatory to reduce the risk of complications. Using RNS, instead of a manual approach for LAI-line ablation may facilitate creation of a bidirectional LAI-block.
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