Cardiovascular Disease |

Robotic Ablation Versus Manual Ablation for Treatment of Atrial Fibrillation: A Meta-analysis FREE TO VIEW

Mahesh Anantha Narayanan, MD; Saurabh Aggarwal, MD; Rohit Loomba, MD; Navdeep Gupta, MD; Venkata Alla, MD; Hussam Abuissa, MD; Aryan Mooss, MD
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Creighton University School of Medicine, Omaha, NE

Chest. 2015;148(4_MeetingAbstracts):73A. doi:10.1378/chest.2268913
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SESSION TITLE: Cardiovascular Disease Student/Resident Case Report Posters

SESSION TYPE: Student/Resident Case Report Poster

PRESENTED ON: Tuesday, October 27, 2015 at 01:30 PM - 02:30 PM

INTRODUCTION: Robotic ablation of atrial fibrillation is an emerging technique in the field of electrophysiology. Though robotic ablation (RA) has been increasingly used for the treatment of atrial fibrillation, its efficacy and safety compared to manual ablation (MA) are not clear.

CASE PRESENTATION: We searched Pubmed, EBSCO and Cochrane databases for randomized studies in English language with terms “robotic navigation system”, “robotic ablation”, “manual ablation”, “conventional ablation”, “atrial fibrillation” and their combinations. The fixed-effects model was used for analysis of homogenous end points, and the random-effects model for heterogeneous end points. Cochrane’s Q statistics were calculated and used to determine the heterogeneity of included studies for each end point. P<0.05 was considered significant.

DISCUSSION: Compared to MA, RA was associated with significant reduction in total fluoroscopic time (mean difference (MD): -0.927, 95% CI: -1.345 to -0.510; P<.00001). No significant differences were noted between the two groups for the total procedure time (MD: -0.019, 95% CI: -0.275 to 0.238; P=0.88), immediate success rate (odds ratio (OR): 0.883, 95% CI: 0.419 to 1.863; P=0.74) or immediate major complication rate (OR: 1.428, 95% CI: 0.655 to 3.113, P=0.37).

CONCLUSIONS: Robotic ablation is a novel technique being used more frequently nowadays due to excellent catheter stability, easy learning curve and good operator comfort1. With recent studies reporting increasing incidence of cataracts, brain and neck tumors in interventional cardiologists2,3, it is essential to reduce the total fluoroscopic exposure time for physicians. Robotic ablation was associated with significantly lower fluoroscopic exposure time when compared to manual ablation for the treatment of atrial fibrillation. This has great significance for practising clinicians. The total procedure time, immediate success and major complication rates were similar in the two groups.

Reference #1: Schmidt B, Tilz RR, Neven K, Julian Chun KR, Furnkranz A, Ouyang F. Remote robotic navigation and electroanatomical mapping for ablation of atrial fibrillation: Considerations for navigation and impact on procedural outcome. Circ Arrhythm Electrophysiol. 2009;2(2):120-128.

Reference #2: Jacob S, Boveda S, Bar O, et al. Interventional cardiologists and risk of radiation-induced cataract: Results of a french multicenter observational study. Int J Cardiol. 2013;167(5):1843-1847.

Reference #3: Roguin A, Goldstein J, Bar O, Goldstein JA. Brain and neck tumors among physicians performing interventional procedures. Am J Cardiol. 2013;111(9):1368-1372.

DISCLOSURE: The following authors have nothing to disclose: Mahesh Anantha Narayanan, Saurabh Aggarwal, Rohit Loomba, Navdeep Gupta, Venkata Alla, Hussam Abuissa, Aryan Mooss

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