Electrophysiologists at the Cardiovascular Center are the first in New England and among only a few nationwide to offer robotic catheter ablation – an innovative technique using robotic assistance for improved catheter positioning and control.
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Movements at the console are translated to catheter movement - enabling enhanced control over traditional techniques for navigation and placement of catheters.
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Laurence M. Epstein, MD, Chief of the Cardiac Arrhythmia Service at Brigham and Women’s Hospital, is the first in New England and among only a few nationwide to offer robotic catheter ablation – an innovative technique using robotic assistance for improved catheter positioning and control during ablation for the treatment of cardiac arrhythmias.
The robotic system offers three dimensional views of the patient’s anatomy with six degrees of freedom and forcesensing quantification to enable more control over navigation and placement of the catheters in the atria. In addition, the system’s catheters are comprised of inner and outer guide catheters that facilitate access to difficult-toreach cardiac anatomy.
The robotic catheter ablation technique allows more finite manipulation of catheters in areas key to successful ablation, including pulmonary vein openings – often numerous in the origin of cardiac arrhythmias.
Partnering with Referring Physicians in the Care of Patients with
Cardiac Arrhythmias
The Cardiac Arrhythmia Service is a renowned resource for referring physicians, helping manage patients with complex cardiac arrhythmias and offering the full spectrum of support from advice and consultation through advanced treatment modalities, including:
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Catheter ablation of difficult-to-manage arrhythmias, including atrial fibrillation;
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Implantable cardioverter-defibrillator (ICD) placement;
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Cardiac resynchronization;
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Laser extraction of transvenous pacemaker and ICD leads;
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Antiarrhythmic drug therapy;
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Investigational devices and ablation technologies.
Information and Referrals
For more information regarding the Cardiac Arrhythmia Service at Brigham and Women’s Hospital, please contact our Referral Coordinators at (617) 732-9894 or bwhteleservices@partners.org.
Case Study
Background
A 45-year-old male patient with atrial tachycardia presented with asymptomatic fluttering. The patient noticed the arrhythmia on his heart rate monitor during exercise. A vigorous and competitive rower, the patient was eventually unable to participate in competitive training at his desired level after an arrhythmic episode induced shortness-of-breath.
Evaluation
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This image shows a three dimensional anatomic map of the patient’s heart and areas identified for ablation.
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The patient’s echocardiogram was normal. His resting heart rate was 57 beats per minute. While his stress test was negative, the patient experienced an arrhythmic episode during Level 6 of the test. At the peak of the episode, the patient’s heart rate increased to 226 beats per minute.
Treatment at Brigham and Women’s Hospital
In September 2007, the patient underwent a robotic catheter ablation for the treatment of atrial tachycardia. Performed by Laurence M. Epstein, MD, the procedure took approximately three hours to complete. Ablation was performed using radiofrequency energy delivered by catheters positioned by robotic assistance.
Post procedure
The patient was able to resume training one week following the procedure. Follow-up stress test showed resting heart rate between 70 and 75 beats per minute. At Level 6 of the test, the patient’s heart rate was 160 beats per minute. On October 20, 2007, less than one month after the procedure, the patient competed in the Head of the Charles Regatta race in Boston, MA.
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