Catheter Ablation – New Developments in Robotics

Abstract

Catheter ablation has become the curative treatment modality for various arrhythmias. Extending the indications for catheter ablation from simple supraventricular tachycardias to complex arrhythmias such as ventricular tachycardia or atrial fibrillation, the investigator faces prolonged procedure times, fluoroscopy exposure and the need for stable and reproducible catheter movement. Recently, remote-controlled robotic catheter ablation has emerged as a novel ablation concept to meet these requirements. This review describes the two available robotic ablation systems and summarizes their clinical applications and current human experience.

Steerable catheters in minimally invasive vascular surgery

“…The magnetic catheter of Niobe and the Artisan  control catheter of Sensei are two representative steerable catheters. There are already several reviews focused on comparison of these two novel RCNSs, based on clinical experiences in humans (2,3). However, other steerable catheters under investigation are not being taken into account.…”

“…However, conventional catheters are difficult to steer and control (1) and there is an accompanying risk of complications, such as dissection or perforation (2,3), for the following reasons:…”

Evaluation of a new epicardial cryoablation system for the treatment of Cardiac Tachyarrhythmias

“…A variety of drugs are used to treat AF including amiodarone derivatives, atrium selective channel blockers and gap junction modulators. While other agents are being tested, they all have a degree of toxicity and limited effectiveness which has led to the development of devices designed to generate a set of lesions to prevent arrhythmias [9,[11][12][13][14][15]. Studies comparing ablation to pharmacological intervention suggest that ablation may provide a more effective means for maintenance of normal sinus rhythm.…”

Design and performance evaluation of a master controller for endovascular catheterization

“…Two commercially available endovascular simulators are the Procedicus Vascular Interventional System Trainer [5,6] (VIST, Mentice AB, Gothenburg, Sweden) and the Angio Mentor TM [7,8] (Simbionix, Ltd., Cleveland, OH, U.S.), which allow novice interventionalists to conduct comprehensive, goal-oriented training during their education program before treating real patients including catheter/wire manipulating, stent deployment and angioplasty balloon inflation in the renal, carotid, aortoiliac and peripheral vascular structures [9]. The Sensei robotic navigation system [10,11] (Hansen Medical, Mountain View, Calif) and the Niobe magnetic navigation system [12,13] (Stereotaxis, St. Louis, Mo) are two typically commercial surgical robotic systems that have been used in endovascular interventional surgery with electromechanical bases and magnetically controlled mechanisms of action. They have been successfully used in different clinical applications including cardiac ablation and endovascular aneurysm repair [14].…”