title: Right-side RF ablation using remote catheter navigation: experimental results in vivo.
abstract: BACKGROUND
  The close proximity between the interventionalist and patient during catheter-based interventions for cardiac arrhythmia exposes the interventionalist to harmful radiation. A prototype remote catheter navigation system (RCNS) has been developed to reduce occupational dose. The safety, feasibility of this RCNS and a comparison of remote and conventional navigation techniques is investigated in vivo.
  
  
  METHODS
  Seven anatomical locations in the right side of the heart in porcine models were chosen as navigation targets. Using fluoroscopy and electrogram analysis, an experienced electrophysiology interventionalist manipulated a radiofrequency (RF) ablation catheter to each target using the RCNS and conventional navigation. Success rate, navigation time, exposure, exposure time and procedure time was recorded for all anatomical targets. Time to integrate the RCNS with the procedure suite was also measured.
  
  
  RESULTS
  All targets were successfully reached with the RCNS and conventional navigation. No erratic catheter motion was observed with the RCNS whereas 1 operation failure occurred. The anatomical targets were found to have the largest effect on navigation time (P < 0.05), exposure (P < 0.05), and exposure time (P < 0.01), although the navigation method had little to no effect on the metrics. These results suggest that remote navigation procedures can be performed with navigation times comparable to conventional bedside navigation.
  
  
  CONCLUSIONS
  Remote navigation with the RCNS may present a safe method of reducing occupational dose, while providing comparable navigation time with conventional bedside navigation.
authors.affiliation: Graduate Program in Biomedical Engineering, Robarts Research Institute, London, Ontario, Canada. yogesh.thakur@vch.ca
authors.forename: Yogesh
authors.initials: Y
authors.lastname: Thakur
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Jones
authors.forename: Allan
authors.initials: A
authors.lastname: Skanes
authors.forename: Raymond
authors.initials: R
authors.lastname: Yee
authors.forename: Maria
authors.initials: M
authors.lastname: Drangova
mesh_terms: D000818:Animals; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D022062:Electrophysiologic Techniques, Cardiac; D004867:Equipment Design; D005240:Feasibility Studies; D005471:Fluoroscopy; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D023421:Models, Animal; D016273:Occupational Exposure; D011829:Radiation Dosage; D015641:Radiography, Interventional / Q000379:methods; D012371:Robotics / Q000295:instrumentation; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation; D013552:Swine; D013997:Time Factors