Experience of robotic catheter ablation in humans using a novel remotely steerable catheter sheath.
Experience of robotic catheter ablation in humans using a novel remotely steerable catheter sheath.
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DOI：
10.1007/s10840-007-9184-z
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发表时间：
2008-01
影响因子：
1.8
通讯作者：
Davies, D. Wyn
中科院分区：
文献类型：
--
作者：
Kanagaratnam, Prapa;Koa-Wing, Michael;Wallace, Daniel T.;Goldenberg, Alex S.;Peters, Nicholas S.;Davies, D. Wyn
已经开发了一种新型的远程控制可操纵导引导管，以实现心脏内任何8 Fr或更小的电生理导管的精确操作和稳定定位，用于标测和消融。报告我们使用该系统对人体进行远程导管消融的初步经验。招募参加常规消融的连续患者。通过左股静脉插入各种常规诊断导管，准备治疗旁路（n = 1）、房扑（n = 2）和房颤（n = 7）。将可控导引导管插入右股静脉，通过该静脉使用各种灌注和非灌注头端消融导管。常规终点（通路传导丧失、双向三尖瓣环峡部阻滞和四条肺静脉隔离）用于确定即刻手术成功率。10名患者使用传统和/或3D非透视标测技术进行了远程导管消融。使用机器人控制系统实现了所有手术终点，无需手动操作消融导管。无严重并发症。尽管所有10次消融手术的平均累积剂量面积积为7，281.4 cGycm 2，但位于操作员旁边距离X射线源2.7 m处的辐射剂量计显示暴露可忽略不计。在各种心律失常中，使用新型遥控可操纵导引导管可实现安全且临床有效的消融导管远程导航。该系统与当前的标测和消融技术兼容。远程导航大大减少了操作员的辐射暴露。本文的在线版本（doi：10.1007/s10840-007-9184-z）包含补充材料，可供授权用户使用。
A novel remotely controlled steerable guide catheter has been developed to enable precise manipulation and stable positioning of any eight French (Fr) or smaller electrophysiological catheter within the heart for the purposes of mapping and ablation. To report our initial experience using this system for remotely performing catheter ablation in humans. Consecutive patients attending for routine ablation were recruited. Various conventional diagnostic catheters were inserted through the left femoral vein in preparation for treating an accessory pathway (n = 1), atrial flutter (n = 2) and atrial fibrillation (n = 7). The steerable guide catheter was inserted into the right femoral vein through which various irrigated and non-irrigated tip ablation catheters were used. Conventional endpoints of loss of pathway conduction, bidirectional cavotricuspid isthmus block and four pulmonary vein isolation were used to determine acute procedural success. Ten patients underwent remote catheter ablation using conventional and/or 3D non-fluoroscopic mapping technologies. All procedural endpoints were achieved using the robotic control system without manual manipulation of the ablation catheter. There was no major complication. A radiation dosimeter positioned next to the operator 2.7 m away from the X-ray source showed negligible exposure despite a mean cumulative dose area product of 7,281.4 cGycm2 for all ten ablation procedures. Safe and clinically effective remote navigation of ablation catheters can be achieved using a novel remotely controlled steerable guide catheter in a variety of arrhythmias. The system is compatible with current mapping and ablation technologies Remote navigation substantially reduces radiation exposure to the operator. The online version of this article (doi:10.1007/s10840-007-9184-z) contains supplementary material, which is available to authorized users.
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影响因子：
24
作者：
Pappone, C;Vicedomini, G;Santinelli, V
通讯作者：
Santinelli, V
DOI：
10.1007/s10840-005-0325-y
发表时间：
2005-04-01
影响因子：
1.8
作者：
Al-Ahmad, A;Grossman, JD;Wang, PJ
通讯作者：
Wang, PJ
影响因子：
2.6
作者：
McFadden, SL;Mooney, RB;Shepherd, PH
通讯作者：
Shepherd, PH
影响因子：
6.1
作者：
Efstathopoulos, Efstathios P.;Katritsis, Demosthenes G.;Faulkner, Keith
通讯作者：
Faulkner, Keith
DOI：
10.1111/j.1540-8167.2006.00556.x
发表时间：
2006-10-01
影响因子：
2.7
作者：
Saliba, Walid;Cummings, Jennifer E.;Natale, Andrea
通讯作者：
Natale, Andrea