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01.02.2016 | Original Paper

Experience matters: long-term results of pulmonary vein isolation using a robotic navigation system for the treatment of paroxysmal atrial fibrillation

verfasst von: Andreas Rillig, Tina Lin, Boris Schmidt, Britta Feige, Christian Heeger, Jascha Wegner, Erik Wissner, Andreas Metzner, Anita Arya, Shibu Mathew, Peter Wohlmuth, Feifan Ouyang, Karl-Heinz Kuck, Roland Richard Tilz

Erschienen in: Clinical Research in Cardiology | Ausgabe 2/2016

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Abstract

Background

Long-term results after circumferential pulmonary vein isolation (CPVI) for the treatment of paroxysmal atrial fibrillation (PAF) using a robotic navigation system (RNS) have not yet been reported.

Objective

To evaluate long-term results of patients with PAF after CPVI using RNS.

Methods

In this study, 200 patients (n = 151 (75.5 %) male; median age 62.2 (54.7–67.7) years) with PAF were evaluated. In 100 patients, RNS (RN-group) was used for CPVI and compared to 100 manually ablated control patients (MN-group). Radiofrequency was used in conjunction with 3D electroanatomic mapping. Power was limited to 30 watts (W) at the posterior left atrial (LA) wall in the first 49 RNS patients (RN-group-a). After esophageal perforation occurred in one RN-group-a patient, maximum power was reduced to 20 W for the subsequent 51 patients (RN-group-b).

Results

After a median follow-up of 2 years, single (77/100 vs 77/100, p = 0.89) and multiple (90/100 vs 93/100, p = 0.29) procedure success rates were comparable between RN-group and MN-group. Single procedure success rate was significantly lower in RN-group-a as compared to RN-group-b (65.3 vs 88.2 %, p = 0.047). In RN-group-a patients, procedural times [200 (170–230) vs 152 (132–200) minutes, p < 0.01] and fluoroscopy times [16.6 (12.9–21.6) minutes vs 13.7 (9.5–19) minutes, p = 0.043] were significantly longer compared to RN-group-b patients.

Conclusion

Long-term success rate after CPVI using RNS was comparable to manual ablation. Despite a lower power limit of 20 W at the posterior LA wall, single procedure success rate was higher in RN-group-b as compared to RN-group-a. Procedure time and fluoroscopy time decreased, whilst success rate increased with increasing experience in the RN-group.

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Titel: Experience matters: long-term results of pulmonary vein isolation using a robotic navigation system for the treatment of paroxysmal atrial fibrillation
verfasst von: Andreas Rillig
Tina Lin
Boris Schmidt
Britta Feige
Christian Heeger
Jascha Wegner
Erik Wissner
Andreas Metzner
Anita Arya
Shibu Mathew
Peter Wohlmuth
Feifan Ouyang
Karl-Heinz Kuck
Roland Richard Tilz
Publikationsdatum: 01.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 2/2016
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-015-0892-6

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Springer Medizin

Experience matters: long-term results of pulmonary vein isolation using a robotic navigation system for the treatment of paroxysmal atrial fibrillation

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Objective

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Results

Conclusion

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