Saliba W et al. (2008) Atrial fibrillation ablation using a robotic catheter remote control system: initial human experience and long-term follow-up results. J Am Coll Cardiol 51: 2407–2411

The success of manual catheter ablation of arrhythmogenic foci depends on the operator's skill and experience. Saliba and colleagues' preliminary study in humans has demonstrated that remote-controlled robotic catheter ablation of atrial fibrillation (AF) is feasible and safe. This approach could overcome the limitations of manual catheter manipulation.

This prospective study enrolled 40 ablation-naive patients (mean ± SD age 57 ± 20 years, 29 men) with drug-refractory AF, from three European medical centers. First, the hollow catheter sheath of the Sensei Robotic Catheter System® (Hansen Medical, Mountain View, CA) was manually positioned in the inferior right atrium. The sheath was then robotically steered into the left atrium via a transeptal puncture and the ablation catheter inserted. Ablation of the pulmonary vein antra continued under robotic control until the pulmonary veins and superior vena cava were electrically isolated. Two patients developed pericardial tamponade during pulmonary-vein isolation, which resolved with pericardiocentesis. The 23 patients who had atrial flutter as well as AF additionally underwent ablation of the posterior cavotricuspid isthmus. After 1 year, 34 patients were free from atrial arrhythmias without the use of antiarrhythmic medication. No pulmonary vein stenoses were reported.

The authors concluded that the safety and efficacy of this robotic system is similar to that of conventional catheter ablation and recommend that a randomized, controlled trial of the two strategies be initiated.