4 â Department of Cardiology, University Hospitals of Leicester, Glenfield Hospital, UK. Background & Objectives. Robotic AF ablation may be safer for operators ...
Exploring the relationship between contact force and clinical outcomes between Human and Robot-assisted AF ablation: early results of MAST-AF Chu GS 1, Chin SH 1, Winter J 1, Armstrong S 4, Masca N 2, Almeida TP 3, Brown PD 1, Schlindwein FS 3, Ng GA 1,2 1 – Department of Cardiovascular Sciences, University of Leicester, UK 2 – NIHR Leicester Cardiovascular Biomedical Research Unit, Leicester, UK 3 – Department of Engineering, University of Leicester, UK 4 – Department of Cardiology, University Hospitals of Leicester, Glenfield Hospital, UK
Background & Objectives Robotic AF ablation may be safer for operators and more efficacious for patients. We aimed to compare clinical outcomes and contact force between conventional Manual vs. Amigo robotically-assisted AF ablation. Method Our UK tertiary centre is pioneering a prospective randomized trial (NCT01583855) comparing Manual versus robotic control with the Amigo Remote Catheter System (Catheter Robotics Inc.), both using the SmartTouch force-sensing catheter and Carto 3 (Biosense Webster), in AF ablation (MAST-AF trial). Left and Right WACA were performed whilst blinded to force data, with electrical PV isolation at 30 min as the endpoint. WACA force data was grouped by region using a clock face model (fig. 1) and analysed retrospectively by a separate physician blinded to the trial arm. A mixed-model ANOVA was fitted to log-transformed data, using planned contrasts to compare the groups. Clinical data was compared using 2-sample t-tests.
Results Both arms show similar initial results (Table 1). Each had 1 minor vascular complication (not requiring intervention). Atypical flutter was seen in 1 patient in the manual arm 6.7 months post-ablation.
3329 ablation points were analysed, totalling 662,471 force data elements. A trend towards higher force values was observed anterior to the RPV ostia (RWACA 1-5, fig. 2), particularly for Amigo cases. Conclusion Our initial data indicates similar clinical outcomes with robotic and human ablation. Catheter force values are higher anterior to the RPV ostia, and is amplified by Amigo assistance. Completion of recruitment and one year follow-up is awaited.
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