title: Worldwide experience with the robotic navigation system in catheter ablation of atrial fibrillation: methodology, efficacy and safety.
abstract: BACKGROUND
  The Hansen Robotic system has been utilized in ablation procedures for atrial fibrillation (AF). However, because of the lack of tactile feedback and the rigidity of the robotic sheath, this approach could result in higher risk of complications. This worldwide survey reports a multicenter experience on the methodology, efficacy, and safety of the Hansen system in AF ablations.
  
  
  RESULTS
  A questionnaire addressing questions on patient's demographics, procedural parameters, ablation success rate and safety information was sent to all centers where more than 50 robotic AF ablation cases have been performed. From June 2007 to December 2009, 1,728 procedures were performed at 12 centers utilizing the Hansen robotic navigation technology. The overall complication rate was 4.7% and the success rate was 67.1% after 18 ± 4 months of follow-up. In 5 low volume centers there appeared to be a learning curve of about 50 cases (complication rate 11.2% for the first 50 cases vs 3.7% for the 51-100 cases; P = 0.044) and a trend showing a decrease of complication rate with increasing case volume. However, in the remaining 7 centers no learning curve was present and the complication rate was stable over time (3.7% for the first 50 cases vs 3.6% for the 51st case thereafter; P = 0.942).
  
  
  CONCLUSIONS
  The Hansen robotic system can be used for AF ablation safely. In low volume centers, there appeared to be a learning curve of the first 50 cases after which the complication rate decreased. With a higher case volume, the success rate increased.
authors.affiliation: Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, TX, USA.
authors.forename: Rong
authors.initials: R
authors.lastname: Bai
authors.forename: Luigi
authors.initials: L
authors.lastname: DI Biase
authors.forename: Miguel
authors.initials: M
authors.lastname: Valderrabano
authors.forename: Faizel
authors.initials: F
authors.lastname: Lorgat
authors.forename: Hanka
authors.initials: H
authors.lastname: Mlcochova
authors.forename: Roland
authors.initials: R
authors.lastname: Tilz
authors.forename: Udo
authors.initials: U
authors.lastname: Meyerfeldt
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Hranitzky
authors.forename: Oussama
authors.initials: O
authors.lastname: Wazni
authors.forename: Prapa
authors.initials: P
authors.lastname: Kanagaratnam
authors.forename: Rahul N
authors.initials: RN
authors.lastname: Doshi
authors.forename: Douglas
authors.initials: D
authors.lastname: Gibson
authors.forename: André
authors.initials: A
authors.lastname: Pisapia
authors.forename: Prasant
authors.initials: P
authors.lastname: Mohanty
authors.forename: Walid
authors.initials: W
authors.lastname: Saliba
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
authors.forename: Josef
authors.initials: J
authors.lastname: Kautzner
authors.forename: G Joseph
authors.initials: GJ
authors.lastname: Gallinghouse
authors.forename: Andrea
authors.initials: A
authors.lastname: Natale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000601:surgery*; D017115:Catheter Ablation / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data; D004867:Equipment Design; D005260:Female; D019538:Health Care Surveys; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D006801:Humans; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061214:Patient Safety / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000209:etiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012371:Robotics / Q000295:instrumentation / Q000706:statistics & numerical data*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000295:instrumentation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome