MAPPING AND NAVIGATION USING ROBOTIC NAVIGATION SYSTEM
Case presented by:
A 41-year-old patient with essential hypertension and diabetes was admitted to our institution for catheter ablation of atrial fibrillation (AF) with the Sensei® robotic system (Hansen Medical Inc., Mountain View, CA). He had paroxysmal AF refractory to proprafenone and almarythm.
Question No. 1: The operator is burning with an open-irrigated ablation catheter at a flow rate of 30 cc/min in power control mode with 40 watts at 42° C. The system shows an average contact force of 40 grams (Figure 77.1). Based on published data, the operator should:
A.Decrease the power to 35 W.
B.Decrease the power to 30 W and reduce the contact force to 20–30 grams.
C.Increase the contact force to 50 grams.
D.Increase the power to 45 W and the contact force to 45 grams.
E.None of the above.
Figure 77.1. Left: NavX™ (St. Jude Medical Inc., St. Paul, MN) three-dimensional (3D) mapping posterior view showing the lesion set and mapping catheters (circular mapping catheter in blue; coronary sinus (CS) catheter in yellow). Below the map the “IntelliSense®” technology (Hansen Medical) shows an average contact force of 40 grams. Top right: Fluoroscopic left anterior oblique (LAO) view showing the ablation catheter and the circular mapping catheter at the level of the right pulmonary veins (PV). Bottom right: Intracardiac echocardiography (ICE) view on the console screen shot.
Description of the Hansen Robotic Catheter System
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