Aim: Robotic control of the ablation catheter allows to reduce radiation exposure and to increase comfort for the operator. Our aim is to evaluate immediate and long term efficacy of atrial fibrillation ablation with the AMIGO™ robotic arm comparing to manual navigation.
Methods: BWe evaluated 14 consecutive patients submitted to atrial fibrillation ablation with robotic arm (group A) and compared to 17 consecutive patients submitted to ablation with manual navigation during the same time interval (control group B). The same catheter and mapping system were used in both groups- Smarttouch® and CARTO®. Baseline characteristics (sex, age, paroxysmal vs persistent atrial fibrillation, presence of structural heart disease and left atrium volume) did not differ significantly (p=ns) between groups. The four pulmonary veins were isolated in all patients of both groups. Cavo-tricuspide isthmus ablation was performed in 4 patients in group A and 6 patients in group B. Additional left atrium lines were performed in one patient of group A. The procedure lasted longer in the robotic group (202 ± 62 vs 138 ± 39 min; p=0.002) but not requiring more fluoroscopy time (23 ± 12 vs 17 ± 8 min; p=ns) or more radiofrequency delivery (48 ± 9 vs 51 ± 46 min; p=ns). During an average follow up of 662±150 days, recurrence free from any documented supraventricular arrhythmia was 85.7%in group A vs 82.4% in group B (p=NS). There were no complications reported in both groups (including major complications and death of any cause).
Conclusions: In this group of consecutive patients submitted to atrial fibrillation, AMIGO™ robotic arm and manual conventional navigation achieved similar efficacy and safety in the immediate and long term. Although the procedure lasted longer, the patient was not exposed to higher fluoroscopy time or to a higher extent of radiofrequency delivery.