Robotic ablation of paroxysmal atrial fibrillation saves time and irradiation dose

We studied 150 patients (pts) (86 males and 64 females) having a mean age of 51.3 yrs (54 > 50, 96 below 50 yrs), who suffered from symptomatic drug refractory paroxysmal AF. Cardiac MSCT image integration to the 3D electroanatomic LA map was used in 106 pts (70.6%, however all of them underwent intracardiac echo guided imaging during the ablation procedure. 40 pts underwent manual RF ablation using CARTO, 40 pts underwent ablation using NavX system, 70 pts underwent robotic ablation using Sensui system. Pulmonary vein isolation was done to all pts using either pulmonary vein (PV) antral isolation in 116 (77.3%) or circumferential pulmonary vein ablation in 34 pts (22.7%). Circumferential PV ablation was usually associated with posterior wall ablation. All pts were followed at 3, 6, 9, and 12 months. 34 Patients (22.6%) developed early recurrence of AF after an initial blanking period of 3 months. We had 16 patients(10.6%) with treatment failure at short term follow up, this number increased to 18 patients (12%) at midterm follow up and further small increase to 20 patients (13.3%) at long term follow up, recurrences were any episode of AF and/or AFL/AT > 30 s after the blanking period. The incidence of recurrence of AF in males was 13% (11/86), 14% in females (9/64), P NS.Comparison between manual and robotic groups as regards ablation points. Groups no. of patientsMeanPTotal no. of ablation pointsManual group8072.20.000∗Robotic group7049.9Total ablation timeManual group802094.80.000∗Robotic group701323.1Total fluoroscopy timeManual group8019.90.000∗Robotic group706.9Total fluoroscopy doseManual group8022570.000∗Robotic group70552.7 None in 92.5%, air embolism zero, cardiac tamponade zero, trivial pericardial effusion 1, groin hematoma 5%, pulmonary vein stenosis >50% zero. No difference in complications between robotic and manual groups. Robotic ablation of paroxysmal atrial fibrillation saves time and irradiation dose.