Early clinical experience of radiofrequency catheter ablation using an audiovisual telesupport system

Heart Rhythm. 2020 May;17(5 Pt B):870-875. doi: 10.1016/j.hrthm.2020.01.018.

Abstract

Background: An audiovisual telesupport system that enables real-time audiovisual communications between 2 long-distance hospitals is one method of telemedicine. The usefulness and safety of radiofrequency catheter ablation (RFCA) using an audiovisual telesupport system has not been well established.

Objective: The purpose of this study was to evaluate the effectiveness and safety of RFCA using an audiovisual telesupport system.

Methods: An audiovisual telesupport system using a strictly secured virtual network was established between Kamisu Saiseikai Hospital (operator with 10 years' experience and 800 procedures) and the University of Tsukuba (advisor with >20 years' experience and 8000 procedures). We evaluated 19 initial consecutive patients who underwent RFCA using this system for tachyarrhythmia: 10 with atrial fibrillation (AF), 5 with paroxysmal supraventricular tachycardia (PSVT), 3 with premature ventricular contraction (PVC), and 1 with atrial flutter. Electrophysiological and procedural characteristics were retrospectively assessed.

Results: Acute success was achieved in all 19 patients without any major complications, with the advisor's audiovisual assistance. Mean procedure time and fluoroscopic time were 161 ± 44 minutes and 24 ± 14 minutes for AF, 110 ± 17 minutes and 28 ± 8 minutes for PVC, and 132 ± 19 minutes and 32 ± 2 minutes for PSVT, respectively. There was no recurrence of clinical arrhythmia in 17 of the 19 patients (89%) during 13 ± 9 month follow-up.

Conclusion: An audiovisual telesupport system for RFCA is a useful and safe method that enabled the electrophysiologist with limited human resources to make an optimal decision regarding procedural strategy and endpoint with the remote advisor's audiovisual assistance.

Keywords: Atrial fibrillation; Catheter ablation; Digital health; Paroxysmal supraventricular tachycardia; Premature ventricular contraction; Telemedicine.

Publication types

  • Multicenter Study

MeSH terms

  • Catheter Ablation / methods*
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Surgery, Computer-Assisted / methods*
  • Tachycardia, Paroxysmal / diagnosis
  • Tachycardia, Paroxysmal / physiopathology
  • Tachycardia, Paroxysmal / surgery*
  • Tachycardia, Supraventricular / diagnosis
  • Tachycardia, Supraventricular / physiopathology
  • Tachycardia, Supraventricular / surgery*
  • Telemedicine / instrumentation*
  • Time Factors
  • Video Recording / instrumentation*