PMID- 25687748
OWN - NLM
STAT- MEDLINE
DCOM- 20160510
LR  - 20220410
IS  - 1532-2092 (Electronic)
IS  - 1099-5129 (Print)
IS  - 1099-5129 (Linking)
VI  - 17
IP  - 8
DP  - 2015 Aug
TI  - A randomized prospective mechanistic cardiac magnetic resonance study correlating 
      catheter stability, late gadolinium enhancement and 3 year clinical outcomes in 
      robotically assisted vs. standard catheter ablation.
PG  - 1241-50
LID - 10.1093/europace/euu364 [doi]
AB  - AIMS: To prospectively compare cardiac magnetic resonance late gadolinium 
      enhancement (LGE) findings created by standard vs. robotically assisted catheter 
      ablation lesions and correlate these with clinical outcomes. METHODS AND RESULTS: 
      Forty paroxysmal atrial fibrillation patients (mean age 54 +/- 13.8 years) 
      undergoing first left atrial ablation were randomized to either robotic-assisted 
      navigation (Hansen Sensei((R)) X) or standard navigation. Pre-procedural, acute (24 
      h post-procedure) and late (beyond 3 months) scans were performed with LGE and 
      T2W imaging sequences and percentage circumferential enhancement around the 
      pulmonary vein (PV) antra were quantified. Baseline pre-procedural enhancements 
      were similar in both groups. On acute imaging, mean % encirclements by LGE and 
      T2W signal were 72% and 80% in the robotic group vs. 60% (P = 0.002) and 76%(P = 
      0.45) for standard ablation. On late imaging, the T2W signal resolved to baseline 
      in both groups. Late gadolinium enhancement remained the predominant signal with 
      56% encirclement in the robotic group vs. 45% in the standard group (P = 0.04). 
      At 6 months follow-up, arrhythmia-free patients had an almost similar mean LGE 
      encirclement (robotic 64%, standard 60%, P = 0.45) but in recurrences, LGE was 
      higher in the robotic group (43% vs. 30%, P = 0.001). At mean 3 years follow-up, 
      1.3 procedures were performed in the robotic group compared with 1.9 (P < 0.001) 
      in the standard to achieve a success rate of 80% vs. 75%. CONCLUSION: Robotically 
      assisted ablation results in greater LGE around the PV antrum. Effective lesions 
      created through improved catheter stability and contact force during initial 
      treatment may have a role in reducing subsequent re-do procedures.
CI  - (c) The Author 2015. Published by Oxford University Press on behalf of the European 
      Society of Cardiology.
FAU - Arujuna, Aruna
AU  - Arujuna A
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK Department of Cardiology, Guy's and St. 
      Thomas' NHS Foundation Trust, London, UK aruna.arujuna@kcl.ac.uk.
FAU - Karim, Rashed
AU  - Karim R
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK.
FAU - Zarinabad, Niloufar
AU  - Zarinabad N
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK.
FAU - Gill, Jaspal
AU  - Gill J
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK.
FAU - Rhode, Kawal
AU  - Rhode K
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK.
FAU - Schaeffter, Tobias
AU  - Schaeffter T
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK.
FAU - Wright, Matthew
AU  - Wright M
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK Department of Cardiology, Guy's and St. 
      Thomas' NHS Foundation Trust, London, UK.
FAU - Rinaldi, C Aldo
AU  - Rinaldi CA
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK Department of Cardiology, Guy's and St. 
      Thomas' NHS Foundation Trust, London, UK.
FAU - Cooklin, Michael
AU  - Cooklin M
AD  - Department of Cardiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
FAU - Razavi, Reza
AU  - Razavi R
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK Department of Cardiology, Guy's and St. 
      Thomas' NHS Foundation Trust, London, UK.
FAU - O'Neill, Mark D
AU  - O'Neill MD
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK Department of Cardiology, Guy's and St. 
      Thomas' NHS Foundation Trust, London, UK.
FAU - Gill, Jaswinder S
AU  - Gill JS
AD  - Division of Imaging Sciences and Biomedical Engineering, King's College London, 
      St. Thomas' Hospital, London SE1 7EH, UK Department of Cardiology, Guy's and St. 
      Thomas' NHS Foundation Trust, London, UK.
LA  - eng
GR  - WT 088641/Z/09/Z/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20150216
PL  - England
TA  - Europace
JT  - Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal 
      of the working groups on cardiac pacing, arrhythmias, and cardiac cellular 
      electrophysiology of the European Society of Cardiology
JID - 100883649
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Atrial Fibrillation/*pathology/*surgery
MH  - Catheter Ablation/*methods
MH  - Contrast Media
MH  - Female
MH  - Gadolinium
MH  - Humans
MH  - Longitudinal Studies
MH  - Magnetic Resonance Imaging, Cine/*methods
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Reproducibility of Results
MH  - Robotic Surgical Procedures/*methods
MH  - Sensitivity and Specificity
MH  - Statistics as Topic
MH  - Surgery, Computer-Assisted/*methods
MH  - Treatment Outcome
PMC - PMC4535555
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Cardiac magnetic resonance imaging
OT  - Catheter ablation
OT  - Long-term follow-up
OT  - Pulmonary vein isolation
OT  - Robotic-assisted
EDAT- 2015/02/18 06:00
MHDA- 2016/05/11 06:00
PMCR- 2015/02/16
CRDT- 2015/02/18 06:00
PHST- 2014/08/18 00:00 [received]
PHST- 2014/11/17 00:00 [accepted]
PHST- 2015/02/18 06:00 [entrez]
PHST- 2015/02/18 06:00 [pubmed]
PHST- 2016/05/11 06:00 [medline]
PHST- 2015/02/16 00:00 [pmc-release]
AID - euu364 [pii]
AID - 10.1093/europace/euu364 [doi]
PST - ppublish
SO  - Europace. 2015 Aug;17(8):1241-50. doi: 10.1093/europace/euu364. Epub 2015 Feb 16.