TY - JOUR
T1 - Robotic catheter ablation of left ventricular tachycardia
T2 - Initial experience
AU - Valderrábano, Miguel
AU - Dave, Amish S.
AU - Báez-Escudero, José L.
AU - Rami, Tapan
N1 - Funding Information:
Supported by National Institutes of Health/National Heart, Lung, and Blood Institute Grants 1R21HL097305-01A1 and 1R41HL104819 , and by the Methodist Hospital Research Institute . Dr. Valderrábano is a consultant to, and receives research support from, Hansen Medical.
PY - 2011/12
Y1 - 2011/12
N2 - Background: Catheter ablation of ventricular tachycardia (VT) can be technically challenging due to difficulty with catheter positioning in the left ventricle (LV) and achieving stable contact. The Hansen Sensei Robotic system (HRS) has been used in atrial fibrillation but its utility in VT is unclear. Objective: The purpose of this study was to test the technical feasibility of robotic catheter ablation of LV ventricular tachycardia (VT) using the HRS. Methods: Twenty-three patients underwent LV VT mapping and ablation with the HRS via a transseptal, transmitral valve approach. Nineteen patients underwent substrate mapping and ablation (18 had ischemic cardiomyopathy, 1 had an apical variant of hypertrophic cardiomyopathy). Four patients had focal VT requiring LV VT mapping and ablation. Procedural endpoints included substrate modification by endocardial scar border ablation and elimination of late potentials, or elimination of inducible focal VT. Results: Mapping and ablation were entirely robotic without requiring manual catheter manipulation in all patients and reaching all LV regions with stable contact. Fluoroscopy time of the LV procedure was 22.2 ± 11.2 minutes. Radiofrequency time was 33 ± 21 minutes. Total procedural times were 231 ± 76 minutes. Complications included a left groin hematoma (opposite to the HRS sheath), 1 pericardial effusion without tamponade that was drained successfully, and transient right ventricular failure in a patient with previous left ventricular assist device. At 13.4 ± 6.7 months of follow-up (range 119 months), recurrence of VT occurred in 3 of 23 patients. Conclusion: Our initial experience suggests that the HRS allows successful mapping and ablation of LV VT.
AB - Background: Catheter ablation of ventricular tachycardia (VT) can be technically challenging due to difficulty with catheter positioning in the left ventricle (LV) and achieving stable contact. The Hansen Sensei Robotic system (HRS) has been used in atrial fibrillation but its utility in VT is unclear. Objective: The purpose of this study was to test the technical feasibility of robotic catheter ablation of LV ventricular tachycardia (VT) using the HRS. Methods: Twenty-three patients underwent LV VT mapping and ablation with the HRS via a transseptal, transmitral valve approach. Nineteen patients underwent substrate mapping and ablation (18 had ischemic cardiomyopathy, 1 had an apical variant of hypertrophic cardiomyopathy). Four patients had focal VT requiring LV VT mapping and ablation. Procedural endpoints included substrate modification by endocardial scar border ablation and elimination of late potentials, or elimination of inducible focal VT. Results: Mapping and ablation were entirely robotic without requiring manual catheter manipulation in all patients and reaching all LV regions with stable contact. Fluoroscopy time of the LV procedure was 22.2 ± 11.2 minutes. Radiofrequency time was 33 ± 21 minutes. Total procedural times were 231 ± 76 minutes. Complications included a left groin hematoma (opposite to the HRS sheath), 1 pericardial effusion without tamponade that was drained successfully, and transient right ventricular failure in a patient with previous left ventricular assist device. At 13.4 ± 6.7 months of follow-up (range 119 months), recurrence of VT occurred in 3 of 23 patients. Conclusion: Our initial experience suggests that the HRS allows successful mapping and ablation of LV VT.
KW - Catheter ablation
KW - Hypertrophic cardiomyopathy
KW - Left ventricular assist device
KW - Robotic navigation
KW - Ventricular tachycardia
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U2 - 10.1016/j.hrthm.2011.07.032
DO - 10.1016/j.hrthm.2011.07.032
M3 - Article
C2 - 21802391
AN - SCOPUS:82455187942
SN - 1547-5271
VL - 8
SP - 1837
EP - 1846
JO - Heart Rhythm
JF - Heart Rhythm
IS - 12
ER -