Robotic Cryoablation

Robotic Surgery for Atrial Fibrillation

Atrial fibrillation is an arrhythmia of the upper chambers of the heart, the atria. It occurs when abnormal electrical signals interfere with the heart’s sinus rhythm (the electrical impulse that triggers a normal heartbeat), causing these chambers to quiver instead of contracting. This condition isn’t life-threatening, since the atria, unlike the ventricles, aren’t responsible for pumping blood to the rest of the body. However, atrial fibrillation increases risk of dangerous blood clots that could result in a stroke, and can also cause uncomfortable symptoms that can affect quality of life.

NYU Langone offers various treatments for atrial fibrillation, including electrocardioversion (in which electrical energy is applied to the atria to restore a normal sinus rhythm), and, for more chronic cases, radiofrequency ablation (RFA). In RFA, which is performed in our electrophysiology lab, a catheter is introduced into the heart through a vein, and radiofrequency energy is applied to carefully selected areas of the atria in order to heat and destroy (ablate) the abnormal electric pathways.

For patients with chronic atrial fibrillation, there may come a point where RFA is no longer effective at controlling their arrhythmia. In these cases, robotic cryotherapy is emerging as a powerful new treatment method. In this approach, our cardiac surgeons use the da Vinci Si surgical robot to freeze (rather than heat) the areas of the heart that are giving rise to the abnormal signals. Because this procedure uses small incisions between the ribs, post-operative discomfort and scarring are minimal. And since the surgeons can see directly into the heart with the robot’s high-definition, 3-D camera, their control over the ablation process is significantly enhanced, allowing them to do a more comprehensive procedure than is possible with RFA.

Robotic Cryotherapy for Atrial Fibrillation at NYU Langone

NYU Langone Medical Center has long been a world leader in the use of non-invasive and minimally-invasive approaches to treating atrial fibrillation and other cardiac conditions. Our robotic cryotherapy procedures are performed by Dr. Didier Loulmet, head of the robotic cardiothoracic surgery program at NYU Langone and a pioneer in the development of robot-assisted cardiac procedures; and Dr. Eugene Grossi, a leader in developing minimally-invasive mitral valve repair techniques. Dr. Loulmet performed the world’s first totally endoscopic robotic coronary artery bypass in 1998 as well as the first totally endoscopic robotic pulmonary vein isolation in 2002, and also assisted on the first robotic mitral valve repair procedure in 1998. In addition to robotic cryotherapy, his robotic surgical practice focuses on robot-assisted mitral valve repair and endoscopic coronary bypass (TECAB and MIDCAB), including hybrid coronary artery bypass/angioplasty procedures. Dr. Grossi, whose practice also includes robotic mitral valve repair, was one of the earliest investigators of robot-assisted approaches to cardiac surgery.

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