Utilisation of Robotic Navigation Systems in the Treatment of Atrial Fibrillation

2010 ◽  
Vol 6 (3) ◽  
pp. 60
Author(s):  
Richard Schilling ◽  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Navigation System ◽  
Antiarrhythmic Drugs ◽  
Rhythm Control ◽  
Navigation Systems ◽  
Robotic Navigation ◽  
Increased Risk ◽  
Common Strategy ◽  
Catheter Navigation

Atrial fibrillation (AF) is linked to an increased risk of adverse cardiovascular events. While rhythm control with antiarrhythmic drugs (AADs) is a common strategy for managing patients with AF, catheter ablation may be a more efficacious and safer alternative to AADs for sinus rhythm control. Conventional catheter ablation has been associated with challenges during the arrhythmia mapping and ablation stages; however, the introduction of two remote catheter navigation systems (a robotic and a magnetic navigation system) may potentially overcome these challenges. Initial clinical experience with the robotic navigation system suggests that it offers similar procedural times, efficacy and safety to conventional manual ablation. Furthermore, it has been associated with reduced fluoroscopy exposure to the patient and the operator as well as a shorter fluoroscopy time compared with conventional catheter ablation. In the future, the remote navigation systems may become routinely used for complex catheter ablation procedures.

Rhythm control: surgical ablation

ESC CardioMed ◽  
2018 ◽  
pp. 2173-2177
Author(s):  
Chawannuch Ruaengsri ◽  
Matthew R. Schill ◽  
Richard B. Schuessler ◽  
Ralph J. Damiano
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Treatment Option ◽  
Surgical Procedures ◽  
Antiarrhythmic Drugs ◽  
Cardiac Surgical Procedures ◽  
Rhythm Control ◽  
Maze Procedure ◽  
Hybrid Procedures ◽  
Surgical Ablation

Surgical ablation for atrial fibrillation was introduced in 1987 and has since become well established as a treatment option for patients with symptomatic atrial fibrillation refractory to antiarrhythmic drugs and/or catheter ablation or patients who are having concomitant cardiac surgical procedures. The Cox–Maze procedure has been improved upon by modern variations using ablation devices. More limited ablation procedures and hybrid procedures have been introduced, but their efficacy requires further investigation.

Worldwide Experience with the Robotic Navigation System in Catheter Ablation of Atrial Fibrillation: Methodology, Efficacy and Safety

2012 ◽  
Vol 23 (8) ◽  
pp. 820-826 ◽  
Author(s):  
RONG BAI ◽  
LUIGI DI BIASE ◽  
MIGUEL VALDERRABANO ◽  
FAIZEL LORGAT ◽  
HANKA MLCOCHOVA ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Navigation System ◽  
Efficacy And Safety ◽  
Robotic Navigation

scholarly journals Rhythm Control for Management of Patients With Atrial Fibrillation: Balancing the Use of Antiarrhythmic Drugs and Catheter Ablation

2011 ◽  
Vol 34 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Juan F. Viles-Gonzalez ◽  
Valentin Fuster ◽  
Jonathan Halperin ◽  
Hugh Calkins ◽  
Vivek Y. Reddy
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Antiarrhythmic Drugs ◽  
Rhythm Control

scholarly journals Current Evidence and Recommendations for Rate Control in Atrial Fibrillation

2013 ◽  
Vol 2 (1) ◽  
pp. 30 ◽  
Author(s):  
Abhishek Maan ◽  
Moussa Mansour ◽  
Jeremy N Ruskin ◽  
E Kevin Heist ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Rate Control ◽  
Treatment Strategy ◽  
Antiarrhythmic Drugs ◽  
The Elderly ◽  
Rhythm Control ◽  
Ventricular Rate ◽  
Current Evidence ◽  
Substantial Risk

Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice, which is associated with substantial risk of stroke and thromboembolism. As an arrhythmia that is particularly common in the elderly, it is an important contributor towards morbidity and mortality. Ventricular rate control has been a preferred and therapeutically convenient treatment strategy for the management of AF. Recent research in the field of rhythm control has led to the advent of newer antiarrhythmic drugs and catheter ablation techniques as newer therapeutic options. Currently available antiarrhythmic drugs still remain limited by their suboptimal efficacy and significant adverse effects. Catheter ablation as a newer modality to achieve sinus rhythm (SR) continues to evolve, but data on long-term outcomes on its efficacy and mortality outcomes are not yet available. Despite these current developments, rate control continues to be the front-line treatment strategy, especially in older and minimally symptomatic patients who might not tolerate the antiarrhythmic drug treatment. This review article discusses the current evidence and recommendations for ventricular rate control in the management of AF. We also highlight the considerations for rhythm control strategy in the management of patients of AF.

scholarly journals Strategies for Rhythm Control in Atrial Fibrillation

2020 ◽  
Vol 1 (2) ◽  
pp. 94-107
Author(s):  
Kumar Narayanan
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Control Strategy ◽  
Rate Control ◽  
Antiarrhythmic Drugs ◽  
Rhythm Control ◽  
Significant Morbidity ◽  
Current Review ◽  
Limited Success ◽  
Alternative Current

Atrial fibrillation (AF), the most common arrhythmia encountered worldwide, is associated with significant morbidity. The three important considerations with regard to AF management are stroke prevention, rate control, and rhythm control, with the latter two overlapping to some extent. While antiarrhythmic drugs have had limited success as a rhythm control strategy, being limited by side effects and proarrhythmia, catheter ablation has emerged as a potentially better alternative. Current ablation techniques afford good success for paroxysmal AF, especially when done in experienced centers; however, further improvements and innovations are required to improve results for more persistent forms of AF. The current review critically summarizes the present strategies employed for rhythm control in AF and briefly outlines some of the newer developments in this field.

Abstract 14648: Gender Differences in Procedural Complications Associated With Atrial Fibrillation Catheter Ablation: A Systematic Review and Meta-analysis of 244,353 Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Martin L Campbell ◽  
John Larson ◽  
Talha Farid ◽  
Stacy Westerman ◽  
Michael S Lloyd ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Catheter Ablation ◽  
Gender Gap ◽  
Major Bleeding ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Vascular Complications ◽  
Increased Risk ◽  
Procedural Complications

Introduction: Women undergoing atrial fibrillation catheter ablation (AFCA) have higher rates of vascular complications and major bleeding. However, studies have been underpowered to detect differences in rare complications such as stroke/transient ischemic attack (TIA) and procedural mortality. Methods: We performed a systematic review of databases (PubMed, World of Science, Embase) to identify studies published since 2010 reporting AFCA complications by gender. Six complications of interest were: 1) vascular/groin complications; 2) pericardial effusion/tamponade; 3) stroke/TIA; 4) permanent phrenic nerve injury; 5) major bleeding & 6) procedural mortality. For meta-analysis, random effects models were used when heterogeneity between studies was ≥ 50% (vascular complications, major bleeding) and fixed effects models for other endpoints. Results: Of 5716 citations, 19 studies met inclusion criteria, comprising 244,353 patients undergoing AFCA, of whom 33% were women. Women were older (65.3 ± 11.2 vs. 60.4 ± 13.2 years), more likely hypertensive (60.6 vs. 55.5%) and diabetic (18.3 vs. 16.5%) and had higher CHA 2 DS 2 -VASc scores (3.0 ± 1.8 vs. 1.4 ± 1.4) (p<0.0001 for all comparisons). The rates of all 6 complications were significantly higher in women (Table). However, despite statistically significant differences, the overall incidences of major complications were very low in both genders: stroke/TIA (women 0.51 vs. men 0.39%) and procedural mortality (women 0.25 vs. men 0.18%). Conclusion: Women experience significantly higher rates of AFCA complications. However, the incidence of major procedural complications is very low in both genders. The higher rate of complications in women may be partially attributable to older age and a higher prevalence of comorbidities at the time of ablation. More detailed studies are needed to better define the mechanisms of increased risk in women and to identify strategies for closing the gender gap.

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