Atrial Fibrillation Ablation Using a Robotic Catheter Remote Control SystemInitial Human Experience and Long-Term Follow-Up Results
Walid Saliba, MD*,
Vivek Y. Reddy, MD ,
Oussama Wazni, MD*,
Jennifer E. Cummings, MD*,
J. David Burkhardt, MD*,
Michel Haissaguerre, MD ,
Josef Kautzner, MD ,
Petr Peichl, MD,
Petr Neuzil, MD#,
Volker Schibgilla, MD||,
Georg Noelker, MD||,
Johannes Brachmann, MD||,
Luigi Di Biase, MD*,¶,
Conor Barrett, MD*,
Pierre Jais, MD and
Andrea Natale, MD, FACC, FHRS**,,,*
* Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
Cardiac Arrhythmia Service, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France
Department of Cardiology IKEM-Institute for Clinical and Experimental Medicine, Prague, Czech Republic
|| Department of Cardiology, Klinikum Coburg II, Medizinische Klinik, Coburg, Germany
¶ Department of Cardiology, University of Foggia, Foggia, Italy
# Cardiology Department, Na Homolce Hospital, Prague, Czech Republic
** Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, Texas
Division of Cardiology, Stanford University, Palo Alto, California
Case Western Reserve University, Cleveland, Ohio.
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Figure 1 The Sensei Robotic Catheter System
The entire system is depicted. (A) The workstation, including the master consol, is mobile and can be moved to an area remote from the patient and fluoroscopy. It can depict electrograms, intracardiac echo images, fluoroscopy, and also 3-dimensional navigation images. The instinctive motion controller device is located on the master consol. The physician operator maneuvers the handle guided by the images on the consol (intracardiac echocardiography, fluoroscopy, and electroanatomical maps) to guide the catheter within the body. (B) The remote catheter manipulator (RCM) is mounted to the tableside and connected to the catheter, which is placed inside the cardiovascular system. Movement of the instinctive motion controller is transmitted by the use of motion logic to the RCM, which in turn maneuvers the catheter. The RCM mounts at the bedside and directs the catheter using the steerable catheter/sheath units. With the use of interpreted motion logic, it is able to smoothly transmit the operator's motions of the master input device to the catheter. The Artisan steerable sheath system consists of a steerable guide catheter inside a steerable sheath, which allows the transmission of the operator's movements (via the RCM) to direct the catheter. This complex system allows for motion in 3 dimensions in response to the operator's hand motion.
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