Imperial College London
Dr Tushar Salukhe

DrTusharSalukhe

Faculty of Medicine, National Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)20 7352 8121 ext 2154t.salukhe Website

 
 
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Location

 

Chelsea WingRoyal Brompton Campus

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Summary

 

Publications

Citation

BibTex format

@article{Willems:2010:10.1111/j.1540-8167.2010.01773.x,
author = {Willems, S and Steven, D and Servatius, H and Hoffmann, BA and Drewitz, I and Müllerleile, K and Aydin, MA and Wegscheider, K and Salukhe, TV and Meinertz, T and Rostock, T},
doi = {10.1111/j.1540-8167.2010.01773.x},
journal = {J Cardiovasc Electrophysiol},
pages = {1079--1084},
title = {Persistence of pulmonary vein isolation after robotic remote-navigated ablation for atrial fibrillation and its relation to clinical outcome.},
url = {http://dx.doi.org/10.1111/j.1540-8167.2010.01773.x},
volume = {21},
year = {2010}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - AIMS: A robotic navigation system (RNS, Hansen™) has been developed as an alternative method of performing ablation for atrial fibrillation (AF). Despite the growing application of RNS-guided pulmonary vein isolation (PVI), its consequences and mechanisms of subsequent AF recurrences are unknown. We investigated the acute procedural success and persistence of PVI over time after robotic PVI and its relation to clinical outcome. METHODS AND RESULTS: Sixty-four patients (60.7 ± 9.8 years, 53 male) with paroxysmal AF underwent robotic circumferential PVI with 3-dimensional left atrial reconstruction (NavX™). A voluntary repeat invasive electrophysiological study was performed 3 months after ablation irrespective of clinical course. Robotic PVI was successful in all patients without complication (fluoroscopy time: 23.5 [12-34], procedure time: 180 [150-225] minutes). Fluoroscopy time demonstrated a gradual decline but was significantly reduced after the 30th patient following the introduction of additional navigation software (34 [29-45] vs 12 [9-17] minutes; P < 0.001). A repeat study at 3 months was performed in 63% of patients and revealed electrical conduction recovery in 43% of all PVs. Restudied patients without AF recurrence (n = 28) showed a significantly lower number of recovered PVs (1 (0-2) vs 2 (2-3); P = 0.006) and a longer LA-PV conduction delay than patients with AF recurrences (n = 12). Persistent block of all PVs was associated with freedom from AF in all patients. At 3 months, 67% of patients were free of AF, while reablation of recovered PVs led to an overall freedom from AF in 81% of patients after 1 year. CONCLUSION: Robotic PVI for PAF is safe, effective, and requires limited fluoroscopy while yielding comparable success rates to conventional ablation approaches with PV reconduction as a common phenomenon associated with AF recurrences.
AU  - Willems,S
AU  - Steven,D
AU  - Servatius,H
AU  - Hoffmann,BA
AU  - Drewitz,I
AU  - Müllerleile,K
AU  - Aydin,MA
AU  - Wegscheider,K
AU  - Salukhe,TV
AU  - Meinertz,T
AU  - Rostock,T
DO  - 10.1111/j.1540-8167.2010.01773.x
EP  - 1084
PY  - 2010///
SP  - 1079
TI  - Persistence of pulmonary vein isolation after robotic remote-navigated ablation for atrial fibrillation and its relation to clinical outcome.
T2  - J Cardiovasc Electrophysiol
UR  - http://dx.doi.org/10.1111/j.1540-8167.2010.01773.x
UR  - https://www.ncbi.nlm.nih.gov/pubmed/20455974
VL  - 21
ER  -
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