New robotic system for catheter ablation of cardiac arrhythmias - Sterotaxis

October 01, 2014

By Adam H. Zivin, MD, FACC, FHRS

Swedish recently completed a major upgrade to the Cardiac Electrophysiology Lab at Cherry Hill and is now the only hospital in Washington State with the Stereotaxis system.  This system is a remote navigation (robotic) system used for catheter ablation of cardiac arrhythmias. In contrast to conventional ablation catheters which are steered by the physician using pull wires in the catheter and manual advancement and retraction, the Stereotaxis system accomplishes this hands-free using large external magnets and a small drive motor located at the hub of the introducer sheath in the groin. The ablation catheters are extremely flexible and themselves have small magnets allowing the direction of the catheter to be manipulated by changing the externally applied magnetic field. Steering of the catheter can therefore be done remotely. The position of the catheter within the heart is followed real-time using a non-fluoroscopic 3D mapping system which can be used to create both anatomic geometry and cardiac electrical activation maps.

The system provides several advantages over conventional catheter ablation. First, because the ablation catheter is flexible and the tip is held against the endocardium by the magnetic field, a very stable position is achieved with lower tip pressure and shear forces than seen with a mechanical system, significantly reducing the risk of cardiac perforation. In addition, the maneuverability of the catheter allows it to reach locations within the heart that would be difficult if not impossible to reach with a conventional catheter. Using the non-fluoroscopic system, X-ray exposure to the patient and staff is reduced.