Remote operation for non-fluoroscopic navigation of complex tachycardias
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Remote operation for non-fluoroscopic navigation of complex tachycardias Ignacio García-Bolao 1,2,3 & David Moñino 4 & Roger Marsal 4 & Pablo Ramos 1,3 & Ane Erkiaga 4 & Joana Irezabal 4 & Ramón Albarrán-Rincón 1,3 Received: 29 August 2020 / Accepted: 21 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Remote system operation technology was developed and applied to a non-fluoroscopic navigation system in order to overcome Spanish mobility restrictions caused by Covid-19 pandemic infection and subsequently used routinely. Methods and results Fifty consecutive complex ablations were performed in different days using this technology. All these procedures were assisted remotely with the only intervention of a field clinical specialist located at his home who took full control of the navigation system (keyboard, mouse, and screen) and had bidirectional real-time audio/video feedback with the operating physician. Once the connection was established, the remote field clinical specialist replicated the Rhythmia screen at the remote location with all its features, and interacted identically with the physician, essentially with no perceptible differences from being physically present. There were neither interruptions nor perceptible delays in the bidirectional communications between the remote field clinical specialist and the operating physician during the procedures. Video signal delay ranged from 265 to 325 ms. All the procedures were uneventful. Conclusions Remote system operation allowed full teleoperation of a non-fluoroscopic navigation system (keyboard, mouse, and screen) as well as bidirectional real-time audio/video feedback with the operating physician, providing a fully autonomous remote assistance in 50 complex ablation procedures. This technology ensures workflow continuity and optimal workforce flexibility and has relevant and promising implications in the field of training, teaching, and resource optimization that deserves further development. Keywords Non-fluoroscopic navigation . Remote system operation . Rhythmia . Covid-19 . Telemedicine
1 Introduction As the complexity of the mapping systems continue to increase, electrophysiological procedures often require additional collaboration of non-medical staff such as field clinical Supplementary Information The online version contains supplementary material available at https://doi.org/10.1007/s10840-02000906-8. * Ignacio García-Bolao [email protected] 1
Department of Cardiology and Cardiac Surgery, Arrhythmia Unit, Clinica Universidad de Navarra, Pamplona, Spain
2
School of Medicine, University of Navarra, Avda Pio XII sn, 31008 Pamplona, Spain
3
Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
4
Boston Scientific Corporation, Madrid, Spain
specialists (FCS) to provide on-site support [1–3]. Remote operation of the navigation system could avoid unnecessary exposure of this staff to a high-risk hospital environment. Remote system operation (RSO) is a required functionality for some missio
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