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 1-19 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.
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 1-19 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.
Authors: Arash Aryana; Andre d'Avila; E Kevin Heist; Theofanie Mela; Jagmeet P Singh; Jeremy N Ruskin; Vivek Y Reddy Journal: Circulation Date: 2007-02-12 Impact factor: 29.690
Authors: Angel Arenal; Esteban Glez-Torrecilla; Mercedes Ortiz; Julian Villacastín; Javier Fdez-Portales; Elena Sousa; Silvia del Castillo; Leopoldo Perez de Isla; Javier Jimenez; Jesus Almendral Journal: J Am Coll Cardiol Date: 2003-01-01 Impact factor: 24.094
Authors: Michael Koa-Wing; Pipin Kojodjojo; Louisa C Malcolme-Lawes; Tushar V Salukhe; Nick W F Linton; Aaron P Grogan; Dale Bergman; Phang Boon Lim; Zachary I Whinnett; Karen McCarthy; Siew Yen Ho; Mark D O'Neill; Nicholas S Peters; D Wyn Davies; Prapa Kanagaratnam Journal: J Cardiovasc Electrophysiol Date: 2009-12
Authors: Daniel Steven; Helge Servatius; Thomas Rostock; Boris Hoffmann; Imke Drewitz; Kai Müllerleile; Arian Sultan; Muhammet Ali Aydin; Thomas Meinertz; Stephan Willems Journal: J Cardiovasc Electrophysiol Date: 2009-09-28
Authors: Vishal Luther; Shahnaz Jamil-Copley; Michael Koa-Wing; Matthew Shun-Shin; Sajat Hayat; Nicholas W Linton; Phang Boon Lim; Zachary Whinnett; Ian J Wright; David Lefroy; Nicholas S Peters; D Wyn Davies; Prapa Kanagaratnam Journal: J Interv Card Electrophysiol Date: 2015-04-11 Impact factor: 1.900