Robotic Catheter Navigation for Ablation
Robotic catheter ablation is performed at some centers. Robotic systems could improve navigation of the catheter, keep the catheter in a stable position, and shorten procedure times. In general, robotic catheter ablations have had similar outcomes as traditional (manual) catheter ablation, meaning that the success and complications rates aren’t significantly better or worse. Robotic systems are expensive, so not all centers have them.
Performing catheter ablation with a single point radiofrequency catheter can be technically challenging, particularly for doctors who have not performed many ablations. In theory, using a robot will simplify the procedure and decrease the expertise needed. However, studies that test this theory have not been performed.
A robotic ablation starts the same way as a traditional catheter ablation. The doctor inserts a catheter into the groin and guides the catheter to the right side of the heart. After making a puncture in the septum, the wall that separates the right and left sides of the heart, the doctor leaves the patient’s side and goes to the control system for the robotic system, which is usually located in an adjacent room.
Here are the leading robotic systems used in catheter ablations:
Niobe (Stereotaxis) — Niobe is a magnetic system that only works with the CARTO electroanatomic mapping system and Biosense Webster mapping and ablation catheters. It doesn’t look like a robot, but is considered a robotic system. The patient’s bed lies between two large magnets, which track the movement in the catheter and send the information to the system. The doctor uses a joystick like those used in video games to change the position of the magnets, which then makes the catheters move. People who have a pacemaker or ICD cannot have a Niobe procedure because these devices would be affected by the magnets.
Sensei (Hansen Medical) — Sensei has a robotic arm that is attached to the patient’s bed. It works with both Ensite NaVx and CARTO as well as standard mapping and ablation catheters. Similar to the Niobe system, the doctor uses a joystick to change the catheter’s location. When the doctor moves the joystick in the Sensei system, the robotic arm moves the catheter. See Robotic Technology is Changing the Paradigm for Catheter Ablation Treatment of Atrial Fibrillation to read about the largest study to date comparing Sensei to traditional catheter ablations, which was presented at Boston Atrial Fibrillation Symposium 2010.
Amigo (Catheter Robotics) — Amigo is a less expensive system than Niobe and Sensei and works with a variety of mapping and ablation catheters. It is in a clinical trial in the US.
Artis zeego (Siemens) — Artis zeego uses computed tomography (CT) imaging technology to guide navigation, and is also in clinical studies.
To learn more about advanced imaging and guidance systems, see Electroanatomic Mapping Systems.
To determine whether catheter ablation is appropriate for you, see Are You a Candidate for Catheter Ablation.
Disclaimer: Some companies mentioned on this site may be donors to StopAfib.org but do not receive favored treatment in coverage as atrial fibrillation patients are our first priority.