Robotic Catheter Ablation
Robotic Catheter ablation (CA) is carried out in the specialised Cardiac Angiography Suite. The procedure involves a number of small, flexible tubes (or catheters) being inserted into the artery in the groin, and then guided up into the heart under Xray control. The tips of the catheters are then directed towards the pathways of the abnormal electrical currents. These pathways are ‘ablated’ using small, precise, controlled burns. Some patients feel a slight discomfort during the ablation, despite the sedation, and so more pain relief may be required. The procedure can take between 2-5 hours, depending on the complexities involved.
Success rates using CA are :
- 95-97% of patients with SVT are completely cured although 10-15% may require a further procedure at some point in the future if symptoms return.
- 90% of patients with atrial flutter are completely cured although they may require more than one session of CA, and may they have co-existing rhythm disturbances which may need other forms of treatment.
Risks include:
- Bruising at the groin where the catheter is inserted, and in 1% of patients this may require surgery to close the hole where the catheter was inserted. The DVLA stipulate a 2-day driving ban following ablation although we recommend that you do not drive for a week after the procedure, due to the bruising in the groin.
- Disruption of the normal electrical circuits of the heart requiring insertion of a pacemaker (0.5%-1.0%); and
- Very rarely, death (0.05-0.1%).
A variety of technologies have been employed to improve catheter ablation particularly of complex heart rhythms such as atrial fibrillation. One of these has been the introduction of robotic catheter ablation. There are only a few centres in the UK that have the equipment to perform these, and I am fortunate to be able to use the Hansen Medical Sensei X system at the John Radcliffe Hospital. I now have a large experience with the system and serve as a proctor to physicians from all over the world, demonstrating and teaching them how to use this new technology. This may prove to have benefits both for patients with better success rates, and for the doctors themselves who are less tired with long procedures and can therefore concentrate better and do more cases.