Ablation of atrial fibrillation utilizing robotic catheter navigation in comparison to manual navigation and ablation: single-center experience

Background: Robotic catheter navigation and ablation either with magnetic catheter driving or with electromechanical guidance have emerged in the recent years for the treatment of atrial fibrillation. Objective: The aim of this study was to compare our center's experience of atrial fibrillation ablation using the Hansen Robotic Medical System with our current manual ablation technique in terms of acute and chronic success, as well as procedure time and radiation exposure to both the patient and the operator. Methods: A total of 390 consecutive patients with symptomatic and drug-resistant atrial fibrillation (289 males, 62 ± 11 years) were prospectively enrolled in the study. All patients underwent the procedure either with conventional manual ablation (group 1, n = 197) or with the robotic navigation system (RNS) (group 2, n = 193). Results: The success rate for RNS was 85% (164 patients), while for manual ablation it was 81% (159 patients) (p = 0.264) at 14.1 ± 1.3 months with AADs previously ineffective. Fluoroscopy time was significantly lower for RNS (48.9 ± 24.6 minutes for RNS vs. 58.4 ± 20.1 minutes for manual ablation, P < 0.001). Mean fluoroscopy time was statistically reduced after 50 procedures (61.8 ± 23.2 minutes for first 50 cases vs. 44.5 ± 23.6 minutes for subsequent procedures, P < 0.0001). Conclusion: Robotic navigation and ablation of atrial fibrillation is safe and effective. Fluoroscopy time decreases with experience.