CARDIOVASCULAR JOURNAL OF AFRICA • Vol 24, No 3, April 2013
AFRICA
e9
Case Report
Robotically assisted ventricular tachycardia substrate
modification ablation with the novel Lynx
TM
integrated
sheath and RF ablation catheter
FAIZEL LORGAT, EVAN PUDNEY, HELENA VAN DEVENTER
Abstract
Catheter ablation of ventricular tachycardia (VT) is demand-
ing and time consuming. Robotically controlled catheter
ablation reduces operator fatigue and exposure to X-rays,
and provides greater precision and stability of the cath-
eter. A new flexible, integrated robotic sheath and ablation
catheter has recently been introduced (Lynx
TM
) and used in
atrial ablation procedures.We describe the first VT substrate
modification ablation in the world with the Lynx
TM
robotic
radio frequency ablation catheter.
Keywords:
robotic ablation, ischaemic VT, remote navigation,
Lynx
TM
catheter
Submitted 9/8/12, accepted 5/3/13
Cardiovasc J Afr
2013;
24
: e9–e11
DOI: 10.5830/CVJA-2013-008
Catheter ablation of ventricular tachycardia (VT) is usually
a demanding and time-consuming procedure. Robotically
controlled catheter ablation has the potential to reduce operator
fatigue, with the added advantage of greater precision and
stability of the catheter. Remote navigation also reduces operator
exposure to X-rays.
VT has been successfully ablated using first-generation
robotic technology,
1,2
which is still in its infancy. Improvements
have the potential to further enhance outcomes. A new flexible,
integrated robotic sheath and ablation catheter has recently been
introduced (Lynx
TM
, Hansen Medical, Mountain View, CA) and
used in atrial ablation procedures.
3
We describe the first VT
substrate modification ablation in the world with the new Lynx
TM
robotic radio frequency (RF) ablation catheter.
Case report
The patient was a 78-year-old man with ischaemic heart disease,
diabetes, hypertension and hypercholesterolaemia. In 1991 he
underwent coronary artery bypass surgery. In 2007 he presented
with sustained monomorphic VT which failed simultaneous
treatment with bisoprolol and amiodarone.
A cardiac electrophysiological study was performed.
Ischaemic scar substrate was identified using voltage mapping.
Manual catheter ablation was performed to the posterior lateral
aspect of the mid left ventricle (LV) using the retrograde
approach. Both bisoprolol and amiodarone were successfully
discontinued post ablation.
In early 2009, drug-eluting stents were placed in a vein graft
to the right coronary artery and a diagonal branch of the left
anterior descending (LAD) coronary artery. In July 2010 the left
internal mammary artery occluded and a drug-eluting stent was
placed in the native LAD.
Christiaan Barnard Memorial Hospital, Cape Town, South
Africa
FAIZEL LORGAT, MB Ch B, PhD, FCP (SA),
EVAN PUDNEY, Clin Tech
HELENA VAN DEVENTER, Clin Tech
Fig. 1. Admission ECG demonstrating broad-complex tachycardia with atypical right bundle branch morphology.
