title: Non-randomised comparison of acute and long-term outcomes of robotic versus manual ventricular tachycardia ablation in a single centre ischemic cohort.
abstract: BACKGROUND
  Robotically guided radiofrequency (RF) ablation offers greater catheter stability that may improve lesion depth. We performed a non-randomised comparison of patients undergoing ventricular tachycardia (VT) ablation either manually or robotically using the Hansen Sensei system for recurrent implantable defibrillator (ICD) therapy.
  
  
  METHODS
  Patients with infarct-related scar underwent VT ablation using the Hansen system to assess feasibility compared with patients undergoing manual VT ablation during a similar time period. Power delivery during robotic ablation was restricted to 30 W at 60 s. VT inducibility was checked at the end of the procedure. Pre-ablation ICD therapy burdens over 6 months were compared with post-ablation therapy averaged to a 6-month period.
  
  
  RESULTS
  Twelve consecutive patients who underwent robotic VT ablation were compared to 12 consecutive patients undergoing a manual ablation. Patient demographics and comorbidities were similar in the two groups. A higher proportion of robotic cases were urgent (9/12 (75%)) vs. manual (4/12 (33%)) (p = 0.1). Post-ablation VT stimulation did not induce clinical VT in 11/12 (92%) in each group. There were no peri-procedural complications related to ablation delivery. Patients were followed up for approximately 2 years. Averaged over 6 months, robotic ICD therapy burdens fell from 32 (5-400) events to 2.5 (0-11) (p = 0.015). Therapy burden fell from 14 (10-25) to 1 (0-5) (p = 0.023) in the manual group. There was no difference in long-term outcome (p = 0.60) and mortality (4/12 (33%), p = 1.0).
  
  
  CONCLUSIONS
  Robotically guided VT ablation is both feasible and safe when compared to manual ablation with good acute and long-term outcomes.
authors: Department of Cardiac Electrophysiology, Imperial College Healthcare NHS Trust, London, UK.
authors: Vishal
authors: V
authors: Luther
authors: Shahnaz
authors: S
authors: Jamil-Copley
authors: Michael
authors: M
authors: Koa-Wing
authors: Matthew
authors: M
authors: Shun-Shin
authors: Sajat
authors: S
authors: Hayat
authors: Nicholas W
authors: NW
authors: Linton
authors: Phang Boon
authors: PB
authors: Lim
authors: Zachary
authors: Z
authors: Whinnett
authors: Ian J
authors: IJ
authors: Wright
authors: David
authors: D
authors: Lefroy
authors: Nicholas S
authors: NS
authors: Peters
authors: D Wyn
authors: DW
authors: Davies
authors: Prapa
authors: P
authors: Kanagaratnam
mesh_terms: D000368:Aged; D017115:Catheter Ablation / Q000295:instrumentation / Q000379:methods*; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D008297:Male; D011846:Radio Waves; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D017180:Tachycardia, Ventricular / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome