Epicardial Atrial Ablation Using a Novel Articulated Robotic Medical Probe Via a Percutaneous Subxiphoid Approach.
Epicardial Atrial Ablation Using a Novel Articulated Robotic Medical Probe Via a Percutaneous Subxiphoid Approach.
复制标题
使用新型铰接式机器人医疗探头通过经皮剑突下入路进行心外膜心房消融。
DOI：
10.1097/imi.0b013e31802f43b1
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发表时间：
2006
期刊：
影响因子：
--
通讯作者：
Zenati,MarcoA
中科院分区：
文献类型：
--
作者：
Ota,Takeyoshi;Degani,Amir;Zubiate,Brett;Wolf,Alon;Choset,Howie;Schwartzman,David;Zenati,MarcoA
微创心外膜心房消融术通过使用经皮剑突下入路治疗房颤，目前缺乏专门的技术用于跳动心脏周围的心包内导航。我们已经开发出一种新型的关节式机器人医疗探头，并进行了初步的实验，在猪preparation.MethodsIn五个大的，健康的猪，通过经皮剑突下的方法引入心包腔内的遥控机器人系统。通过左胸端口插入5 mm内镜，实现左心房和左心耳的二次可视化。操作员通过使用主操纵器主动控制机器人的路径。导管，与灌注射频尖端，引导通过机器人的工作端口，以实现心外膜消融的左atrial.ResultsAccess到心包腔和左心房周围的进展是成功的，在所有情况下，没有干扰跳动的心脏，如致命的心律失常，意外出血，和低血压。在所有5例病例中成功进行了心外膜消融。试验期间未观察到不良血流动力学或电生理事件。当动物被处死时，没有目视检测到消融对周围纵隔结构造成的损伤。左心房的组织病理学证实了心房消融。ConclusionsWe已经开发出一种专用的关节式机器人医疗探头，并成功地进行了心外膜左心房射频消融。根据这些初步实验的反馈，下一代原型中的曲率半径和设备的适当可视化正在得到改进。
ObjectiveMinimally invasive epicardial atrial ablation to cure atrial fibrillation through the use of a percutaneous subxiphoid approach currently has a lack of dedicated technology for intrapericardial navigation around the beating heart. We have developed a novel articulated robotic medical probe and performed preliminary experiments in a porcine preparation.MethodsIn five large, healthy pigs, the teleoperated robotic system was introduced inside the pericardial space through a percutaneous subxiphoid approach. Secondary visualization of the left atrium and left atrial appendage was achieved with the use of a 5-mm scope inserted through a left thoracic port. The operator actively controlled the path of the robot by using a master manipulator. The catheter, with an irrigated radiofrequency tip, was guided through the working port of the robot to achieve epicardial ablation of the left atrium.ResultsAccess to the pericardial space and progression around the left atrium was successful in all cases, with no interference with the beating heart such as a fatal arrhythmia, unexpected bleeding, and hypotension. Epicardial ablation was successfully performed in all five cases. No adverse hemodynamic or electrophysiological events were noted during the trials. When the animals were killed, there was no visually detected injury on the surrounding mediastinal structures caused by ablation. Transmural ablation was confirmed by histopathology of the left atrium.ConclusionsWe have developed a dedicated articulated robotic medical probe and successfully performed epicardial left atrial radiofrequency ablation. Based on the feedback from these preliminary experiments, the radius of curvature and proper visualization of the device are being improved in the next generation prototype.