Arrhythmias and Conduction DisturbancesComparison of the Safety and Feasibility of Arrhythmia Ablation Using the Amigo Robotic Remote Catheter System Versus Manual Ablation
Section snippets
Methods
The study protocol was approved by the ethical committee and has been registered in ClinicalTrials.gov (identifier: NCT01834872). All patients provided written informed consent before inclusion.
We prospectively enrolled 50 consecutive patients referred to our electrophysiology (EP) laboratory to treat any type of arrhythmia with catheter ablation, in which we used Amigo RCS. All procedures were performed by 2 operators. As a control group, patients were prospectively recruited by matched
Results
Patient characteristics (Table 1) were similar in both groups. Fifty percent of patients in both groups were left-sided procedures. AF was paroxysmal in 13 patients (57%) of RCS group and in 11 controls (47%). There were 4 VTs: 2 idiopathic, 1 with ischemic cardiomyopathy, and 1 with dilated cardiomyopathy (identical in both groups). The type of ablation catheter that was used in each arrhythmia substrate is shown in the Supplementary material. In the RCS group, a Biosense Webster EZ Steer was
Discussion
In the present study, we report for the first time a series of patients with different types of arrhythmias ablated using the new RCS system. Our results show a significant reduction in operator fluoroscopy exposure with this robotic system while maintaining similar acute efficacy and complication rates compared with the conventional approach.
In addition to the Amigo RCS, there are 2 remote navigation systems commercially available for arrhythmia ablation: Niobe magnetic navigation system
Acknowledgment
The authors thank Luiz Pivotto, EE, and Jennifer Englund, BS, BA, for manuscript preparation.
References (17)
- et al.
Catheter ablation of stable ventricular tachycardia before defibrillator implantation in patients with coronary heart disease (VTACH): a multicentre randomised controlled trial
Lancet
(2010) - et al.
EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias: developed in a partnership with the European Heart Rhythm Association (EHRA), a registered branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA)
Heart Rhythm
(2009) - et al.
Atrial fibrillation ablation using a robotic catheter remote control system: initial human experience and long-term follow-up results
J Am Coll Cardiol
(2008) - et al.
Feasibility and safety of remote-controlled magnetic navigation for ablation of atrial fibrillation
Am J Cardiol
(2008) - et al.
Remote magnetic navigation: human experience in pulmonary vein ablation
J Am Coll Cardiol
(2007) - et al.
Robotic catheter ablation of left ventricular tachycardia: initial experience
Heart Rhythm
(2011) - et al.
Brain and neck tumors among physicians performing interventional procedures
Am J Cardiol
(2013) - et al.
Remote controlled magnetically guided pulmonary vein isolation in canines
Heart Rhythm
(2006)
Cited by (26)
Robotic applications for intracardiac and endovascular procedures
2024, Trends in Cardiovascular MedicineCitation Excerpt :Whilst the available literature on endovascular robotic systems is limited to some case series, overall, the reported results are quite encouraging and all studies agree on the benefits that accompany these robotic systems, including improved accuracy in navigation, steeper learning curves, reduced procedural and fluoroscopy time and better outcomes in complex cases [38]. A summary of the currently available literature on endovascular robots is presented in Table 4 [40–61]. In addition.
Special Problems in Ablation of Accessory Pathways
2019, Catheter Ablation of Cardiac ArrhythmiasRemote Catheter Navigation Systems
2019, Catheter Ablation of Cardiac ArrhythmiasArrhythmia ablation using the Amigo Robotic Remote Catheter System versus manual ablation: One year follow-up results
2016, International Journal of CardiologySafety and feasibility of atrial fibrillation ablation using Amigo<sup>®</sup> system versus manual approach: A pilot study
2018, Indian Pacing and Electrophysiology JournalCitation Excerpt :Additionally Datino et al. [9] evaluated the use of this remote catheter manipulation system in a cohort of 50 consecutive patients referred to ablation procedure for different types of arrhythmias in comparison to 50 matched manual ablation procedures during the same time period. They observed no differences between the two groups in term of efficacy, safety, procedural time, or patient fluoro time, while operator fluoroscopy exposure time was significantly reduced in Amigo group [9]. However, none of these previous studies provided a quantitative evaluation of the contact force applied to the cardiac tissue during the ablation procedures.
See page 831 for disclosure information.