Robotic Catheter Ablation for Atrial Fibrillation

As described previously [10 (link)], the open-irrigated ablation catheter (NaviStar™ RMT ThermoCool™; Biosense Webster, CA, USA) was connected to a 3D mapping system (CARTO™, Biosense Webster, CA, USA or EnSite™, St. Jude Medical, MN, USA) and the RMN Niobe™ ES system (Stereotaxis Inc., St. Louis, MO, USA) to perform 3D LA electroanatomic mapping and ablation. Additional fracture potential ablation or linear ablation might be performed when necessary. The RF current was delivered for 30−40 s per lesion, applying 30–40 W (irrigation flow rate 17 mL/min) with the generator (Stockert, Biosense Webster, CA, USA) in a power-controlled mode. Power was selected based on the location of catheter tip in the LA. Once PV isolation was achieved, electrical cardioversion was attempted. For patients whose rhythm could not be converted to the sinus rhythm, the LA roof line lesion was created by the RMN catheter or cryoballoon, respectively in either group to ease subsequent electrical cardioversion. Substrate modification, such as ablation of complex fractionated atrial electrogram, was not allowed in this study.