Novel robotic catheter remote control system: Feasibility and safety of transseptal puncture and endocardial catheter navigation
Novel robotic catheter remote control system: Feasibility and safety of transseptal puncture and endocardial catheter navigation
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DOI：
10.1111/j.1540-8167.2006.00556.x
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发表时间：
2006-10-01
影响因子：
2.7
通讯作者：
Natale, Andrea
中科院分区：
文献类型：
--
作者：
Saliba, Walid;Cummings, Jennifer E.;Natale, Andrea
目的：本研究的目的是证明机器人导管远程控制系统（CCS）在所有心腔心内膜导航中的安全性和可行性，以及促进房间隔穿刺。背景：CCS 的开发是为了促进心血管系统内导管的控制和精确定位。方法：CCS 由远程导管操纵器、安装关节、医师工作站以及可操纵引导导管（SGC）和护套组成。通过 SGC 插入传统的 4 毫米尖端导管，以对每个心腔中的五个预定义目标进行映射。本研究使用了七只杂种狗。心内超声心动图和三维 (3-D) 电解剖标测与 CCS 集成，以方便导管操作并指导房间隔穿刺。测量完成房间隔穿刺的时间和完成进入每个心腔中预定目标的时间。对进入和消融部位进行肉眼和显微镜检查以评估安全性。结果：所有动物均成功进行房间隔穿刺，平均时间为 7 +/- 3 分钟。进入右心房、右心室、左心房和左心室五个目标的手术时间分别为 5.6 +/- 1.7、4.6 +/- 1.5、13.5 +/- 11.0、7.0 +/- 2.9 分钟。在切除的心脏中没有发现与导管操作相关的心内损伤。结论：使用机器人导管远程控制进行心内膜导管导航和标测是安全可行的。此外，CCS 可用于进行房间隔穿刺和左心房器械操作。
Objectives: The aims of this study were to demonstrate the safety and the feasibility of the robotic catheter remote control system (CCS) in endocardial navigation in all cardiac chambers, as well as facilitation of the transseptal puncture.Background: CCS has been developed to facilitate control and precise positioning of catheters within the cardiovascular system.Methods: CCS consists of a remote catheter manipulator, a set up joint, a physician workstation, and a steerable guide catheter (SGC) and sheath. A conventional 4-mm tip catheter was inserted through the SGC to perform mapping of five predefined targets in each cardiac chamber. Seven mongrel dogs were used in this study. Intracardiac echocardiography and three-dimensional (3-D) electroanatomical mapping were integrated with CCS to facilitate catheter manipulation and to guide transseptal puncture. The time to complete the transseptal puncture and the time to complete access to the predefined targets in each cardiac chamber were measured. Gross and microscopic examinations of the accessed and ablation sites were performed to evaluate safety.Results: Transseptal puncture was performed successfully in all animals with a mean time of 7 +/- 3 minutes. Procedure times to access the five targets in the right atrium, right ventricle, left atrium, and left ventricle were 5.6 +/- 1.7, 4.6 +/- 1.5, 13.5 +/- 11.0, 7.0 +/- 2.9 minutes, respectively. There were no intracardiac damages associated with catheter manipulation noted in the excised hearts.Conclusions: Endocardial catheter navigation and mapping using the robotic catheter remote control is safe and feasible. Moreover, the CCS could be used to perform transseptal puncture and left atrial instrumentation.