title: Robotically controlled ablation for atrial fibrillation: the first real-world experience in Africa with the Hansen robotic system.
abstract: BACKGROUND
  We report the first single-centre experience in Africa with the Sensei X robotic navigation system in an unselected subset of patients with atrial fibrillation (AF).
  
  
  METHODS
  Data were recorded prospectively of all consecutive patients who underwent robotically assisted catheter ablation therapy using the Sensei X robotic navigation system at the Christiaan Barnard Memorial Hospital, Cape Town, South Africa, from July 2009 to July 2010. Outcomes were defined at one and nine months.
  
  
  RESULTS
  A total of 95 patients were included: 63% had only AF and 37% had AF plus atrial flutter. AF was of the persistent type in 81% of patients. The mean procedure, fluoroscopy and ablation times were 220.6 ± 89.6 min, 31.0 ± 20.4 min, and 61.3 ± 28.1 min, respectively. Both fluoroscopy and procedure times were significantly longer for the first 19 patients compared with the remaining 76 patients (43.5 ± 22.7 vs 27.8 ± 18.5 min and 274.7 ± 90.2 vs 207.1 ± 84.7 min, respectively, p = 0.002). The procedural endpoint of the study was successfully achieved in all patients. After one attempt, 27% were discharged from hospital off anti-arrhythmic drugs (AADs). At a median of nine months' follow up, 74% were AF-free off AADs, and 11% were AF-free on AADs, yielding a total freedom from AF of 84% without any redo procedures. Freedom from relapse after 1.12 procedures was 88%.
  
  
  CONCLUSIONS
  The Sensei X robotic navigation system offers a safe and effective approach for the treatment of AF. There was a learning curve with regard to fluoroscopy and procedure time, after which point reduction in radiation exposure and operator strain, as well as improvement in procedure throughputs were even more pronounced.
authors.affiliation: Department of Cardiology, Christiaan Barnard Memorial Hospital, Cape Town, South Africa. florgat@iafrica.com
authors.forename: Faizel
authors.initials: F
authors.lastname: Lorgat
authors.forename: Evan
authors.initials: E
authors.lastname: Pudney
authors.forename: Helena
authors.initials: H
authors.lastname: van Deventer
authors.forename: Sam
authors.initials: S
authors.lastname: Chitsaz
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000000981:diagnostic imaging / Q000601:surgery; D017115:Catheter Ablation / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012371:Robotics / Q000295:instrumentation / Q000379:methods; D013019:South Africa; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome