AtrialFibrillationAblation创新.PDFVIP

View-Synchronized Robotic Image-Guided Therapy for Atrial Fibrillation Ablation Experimental Validation and Clinical Feasibility Vivek Y. Reddy, MD; Petr Neuzil, MD; Zachary J. Malchano, BS; Ragu Vijaykumar, BS; Ricardo Cury, MD; Suhny Abbara, MD; Jiri Weichet, MD; Christina D. McPherson, BS; Jeremy N. Ruskin, MD Background—A robotic catheter navigation system has been developed that provides a significant degree of freedom of catheter movement. This study examines the feasibility of synchronizing this robotic navigation system with electroanatomic mapping and 3-dimensional computed tomography imaging to perform view-synchronized left atrial (LA) ablation. Methods and Results—This study consisted of a porcine experimental validation phase (9 animals) and a clinical feasibility phase (9 atrial fibrillation patients). Preprocedural computed tomography images were reconstructed to provide D o 3-dimensional surface models of the LA pulmonary veins and aorta. Aortic electroanatomic mapping was performed w n manually, followed by registration with the corresponding computed tomography aorta image using custom software. l o a d The mapping catheter was remotely manipulated with the robotic navigation system within the registered computed e d f tomography image of the LA pulmonary veins. The point-to-surface error between the LA electroanatomic mapping data r o m and the computed tomography image was 2.10.7 and 1.6 0.1 mm in the preclinical and clinical studies, respectively. h t t The catheter was