Existing catheter-based approaches for AF are time consuming, complicated, and ineffective in around 20% of cases. The increase in demand for ablative therapy with the growing prevalence of AF has fueled the development of safer and more efficient treatment techniques. Over the last decade, newer electrophysiology technologies have entered the market; these emerging techniques strive to reduce procedure times, eliminate radiation exposure, and achieve permanent destruction of the targeted heart tissue without causing damage to the surrounding structures. The prominent technology among them is remote navigation technology, which uses either use robotics or magnetic fields to steer and direct catheters.

Robotic-guided systems have brought about a shift in the catheter ablation treatment of AF; while the procedure is essentially the same as manual catheter ablation, the use of robotics in allows enhanced precision, stability, and the dexterity needed to perform ablative procedures, with reduced procedure time, also reducing the risk of emboli formation that can potentially lead to lung embolism or stroke. The remote operation of the robotic-guided catheter ablation technique also limits physician’s exposure to fluoroscopy or radiation. The use of long introducers during access helps avoid vascular complications, reducing energy (since the robotic systems provide better contact), and monitoring esophageal temperature helps to avoid any damage.

One such technology is the Sensei Robotic Catheter System, a product of Hansen Medical (Mountain View, CA, USA).The Sensei is an electromechanical system that facilitates catheter navigation via two steerable sheathes incorporating an ablation catheter; both outer and inner sheath are manipulated by a pull-wire mechanism in the robotic arm, which obeys the commands of the central workstation placed in the control room. A master console with multiple video monitors and a three dimensional (3D) joystick facilitate a broad range of motion in any direction.

Magnetic navigation systems, on the other hand, are based on an interaction between a magnetic field of a specific direction and magnitude and multiple tiny magnets on the tip and shaft of the interventional catheter. The Niobe Magnetic Navigation System from Stereotaxis (St. Louis, MO, USA) is currently the only catheter navigation system available. The system employs two permanent magnets that are positioned on either side of the patient, generating a magnetic navigation field, which is less than 10% of the strength of the fields generated by typical magnetic resonance imaging (MRI) equipment. The magnetic field generated is sufficient to steer and change the direction of the magnetically tipped catheters.

However, despite various advantages of remote navigation systems, concerns such as higher system cost, cost involved in renovating the room settings to accommodate the equipment, and catheter compatibility has restricted the wider use of robotic-guided systems and magnetic navigation systems. The global electrophysiology devices market was valued at US$1.1 billion in 2010 and is forecast to reach $1.6 billion by 2017, representing a compound annual growth rate (CAGR) of 6%.

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