Robotics in electrophysiology: Are we near an inflection point?
The development of robotics in electrophysiology (EP) has been a work in progress for decades, but recent advances could be pushing the field toward broader clinical adoption. That's according to Peter Weiss, MD, director of ventricular arrhythmia management and robotics at Banner University of Arizona Medical Center in Phoenix, who spoke on this topic in sessions at Heart Rhythm 2026, the annual Heart Rhythm Society (HRS) meeting, in April.
Weiss said the EP robotics market is reaching an “inflection point” after years of relatively slow development. New U.S. Food and Drug Administration (FDA) clearances are also expanding the technology beyond capital equipment and toward a model that includes procedure-specific disposable devices. He discussed all of this and more during an interview with Cardiovascular Business.
While some robotic companies have come and gone, Stereotaxis has been central to that evolution, Weiss said. The company’s new GenesisX robotic system, cleared by the FDA in late 2025, is a step toward making robotics easier to adopt. It can be installed in an EP lab in roughly three days and does not require extensive room construction or modifications. The system was designed to work with existing X-ray equipment and incorporates self-shielding.
The shift could address one of the major barriers to robotic EP: the substantial upfront investment required for equipment and room construction. Weiss said the ability to rapidly install or remove a system changes the financial equation for hospitals considering robotics.
The company’s acquisition of AccessPoint Technologies also gives Stereotaxis greater control over the catheters and other disposable tools used with its robotic platform. Weiss said this creates a business model more similar to that of cardiac mapping systems, in which capital equipment is placed and the vendor generates longer-term revenue from procedure-related disposables. He said Stereotaxis was able to push forward with new development after a prior partnership agreement with Johnson and Johnson expired.
Remote procedures using telerobotics on the horizon
Remote procedures represent another area of development. Weiss noted the Stereotaxis technology has supported remote procedure demonstrations outside the United States for years, but newer software and connectivity have expanded the concept. An FDA-approved, HIPAA-compliant mobile application now allows physicians to connect to robotic laboratories remotely, potentially enabling consultation and collaboration during procedures.
Taken a step further, this technology might be used eventually for rural and underserved hospitals to expand access to expert care. Weiss said a robotic system could be installed locally where a local physician establishes vascular access, then a specialist located at a larger medical center remotely, possibly hundreds of miles away, performs the complex part of the interventions.
For Banner Health, which operates hospitals across four states, Weiss said such a model could eventually allow specialists in Phoenix to assist with cases in more remote locations without transferring patients to a tertiary center. While this is already technically possible, regulatory and credentialing issues, including physician privileges and state licensure, remain significant hurdles, he said.
Robotics could help expand EP procedures in ASCs
Robotics also could accelerate the migration of EP procedures into ambulatory surgical centers (ASCs). Weiss said his institution is working toward placing a robotic system in an ASC, where procedures such as supraventricular tachycardia and premature ventricular contraction ablations could potentially be performed. Banner already performs remote EP procedures at a series of ASCs it owns partly with the physicians in the suburbs of Phoenix.
He also sees a future role for robotic pulsed field ablation (PFA), including the development of smaller catheters that could eventually enable radial artery access for some atrial fibrillation (AFib) procedures. Such an approach could eliminate the need for transseptal puncture in certain cases and potentially allow patients to leave an ASC approximately an hour after pulmonary vein isolation.
The business case remains a challenge because there is currently no separate reimbursement code for robotic procedures. Weiss said health systems therefore must look beyond direct reimbursement and consider robotics as a potential tool for developing centers of excellence, attracting complex referrals, and improving procedural efficiency.
As PFA becomes increasingly important in AFib treatment, Weiss believes integrating PFA with robotic navigation will be critical to expanding the technology beyond a niche application. The ultimate goal, he said, is for robotics to become an everyday tool across EP and, eventually, endovascular medicine more broadly.
Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: [email protected]