View-Synchronized Robotic Image-Guided Therapy for Atrial Fibrillation Ablation

Reddy, Vivek Y.; Neužil, Petr; Malchano, Zachary J.; Vijaykumar, Ragu; Cury, Ricardo C.; Abbara, Suhny; Weichet, J.; McPherson, Christina D.; Ruskin, Jeremy N.

doi:10.1161/circulationaha.106.677369

Cited by 90 publications

(74 citation statements)

References 20 publications

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“…In conventional VIS, surgeons operate catheter manually in operating room, so there are some disadvantages [1][2]. Firstly, the surgeons are exposed to X-ray for long time, which are harmful to their health.…”

Section: Tsai@buaaeducnmentioning

confidence: 99%

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A New Design of Two-Fingered Catheter Operating Robot for Vascular Interventional Surgery

Cai¹,

Sun

Guan

et al. 2017

IJARA

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It is of great value to design and develop CoR (Catheter-operating Robot) that can substitute a physician to manipulate a catheter in robotic-assisted vascular surgery. In this paper, we designed a new two-fingered CoR to simulate the catheter manipulation by a surgeon with thumb and forefinger, where the rotation and twist motions of the robotic fingers can achieve the conventional push / pull and rotation operation of the catheter respectively, and the open/close motion can achieve the rapid replacement of the catheter or operator. With the novel 'parts reuse' design, as few parts as possible are employed to achieve the two-finger movement in the mechanism structure, which lays a foundation for the miniaturization of the CoR in future. This paper first introduces the design and development of the proposed CoR, and then develops a CoR prototype. The operation precision of the CoR is analyzed by a quantitative experiment, and then a vitro-experiment is carried out to evaluate the validity of CoR in the robot assisted VIS with a glass vascular model. The experimental results show that CoR has the advantages of flexible control and high positioning accuracy, which is convenient for catheter control.

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Section: Tsai@buaaeducnmentioning

confidence: 99%

“…Treat the catheter as a rigid body; the pulse number sent to the translation motor, 1 P in correspondence with the theoretical displacement of the catheter can be calculated using (5), which is derived by (1):…”

Section: Accuracy and Precision Of Catheter Operating Robot Evaluatiomentioning

confidence: 99%

A New Design of Two-Fingered Catheter Operating Robot for Vascular Interventional Surgery

Cai¹,

Sun

Guan

et al. 2017

IJARA

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“…The overall effect is that operators can manipulate catheters from a distance using a 3D navigation handle. 14 Potential advantages of these technologies include increased safety, more precise catheter manipulation and increased stability. 15 A number of studies have demonstrated that the results of PV isolation with remote navigation are comparable with conventional ablation techniques.…”

Section: Remote Navigation Technologies For Af Ablationmentioning

confidence: 99%

New Ablation Technologies and Techniques

Mahida

Berte

Yamashita

et al. 2014

Arrhythmia &Amp; Electrophysiology Review

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Since the first catheter ablation for cardiac arrhythmia more than three decades ago, ablation technology has continually evolved at a rapid pace. Much of the early progress in the field was made in ablation of supraventricular tachycardias. Following a seminal study from Haïssaguerre et al. 1 in 1998, which demonstrated that pulmonary vein triggers are important sources of atrial fibrillation (AF), the approach to management of AF underwent a revolution. Electrical isolation of pulmonary veins (PVs) using catheter ablation became an established therapeutic strategy in patients with paroxysmal AF. During subsequent years, the role of ablation in AF expanded, and more extensive strategies involving ablation of non-pulmonary vein triggers and modification of the left atrial substrate were demonstrated to be effective, even in persistent forms of AF. New Technologies and Techniques for AF AblationCurrently, the most widely used technique for PV isolation involves delivery of point-by-point ablation lesions around the circumference of the vein. A number of different variations to the approach have been developed. During the early stages of PV isolation, a 'segmental approach' which involved targeting the earliest PV potentials at the ostium of the PV was commonly used. Due to high reconnection rates and the risk of PV stenosis, the technique has progressively been modified and the prevailing technique involves circumferential antral ablation to achieve PV isolation. AbstractCatheter ablation is an established treatment strategy for a range of different cardiac arrhythmias. Over the past decade two major areas of expansion have been ablation of atrial fibrillation (AF) and ventricular tachycardia (VT) in the context of structurally abnormal hearts. In parallel with the expanding role of catheter ablation for AF and VT, multiple novel technologies have been developed which aim to increase safety and procedural success. Areas of development include novel catheter designs, novel navigation technologies and higher resolution imaging techniques. The aim of the present review is to provide an overview of novel developments in AF ablation and VT ablation in patients with of structural cardiac diseases.

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“…Navigation in the left atrium is relatively easy and intuitive in most cases. 55,56 Rarely, a patient's anatomy does not allow the outer mechanical sheath to sit well on the septum. This results in movement much like a manual catheter with a sheath that has fallen to the right atrium.…”

Section: Burkhardt and Natale New Technologies In Atrial Fibrillationmentioning

confidence: 99%

New Technologies in Atrial Fibrillation Ablation

Burkhardt

Natale

2009

Circulation

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he treatment of atrial fibrillation has changed greatly in the past decade. Not long ago, the scientific community argued the benefits of a rate-control strategy versus a rhythmcontrol strategy. 1 This argument was always hampered by the relative ineffectiveness of the antiarrhythmic medications used as rhythm-control agents. Ablation therapy for the treatment of atrial fibrillation has quickly evolved. Originally, ablation was focused on finding triggers of atrial fibrillation in the pulmonary veins. 2,3 Now, ablation offers a potential curative strategy for patients with paroxysmal, persistent, or permanent atrial fibrillation. Recent data continue to show that atrial fibrillation ablation is superior to the currently available antiarrhythmic medications in the maintenance of sinus rhythm, and the Food and Drug Administration has approved devices labeled for the ablation of atrial fibrillation. 4 -6 It is estimated that Ͼ2 million people in the United States have atrial fibrillation. 7 Although the number of atrial fibrillation ablations continues to increase year after year, offering this therapy to all potential candidates is impossible because of several limitations. 8,9 A finite number of fellows are being trained in programs that offer a great deal of experience in atrial fibrillation ablation, and there is limited opportunity for practicing electrophysiologists to learn new techniques. Unlike supraventricular tachycardia ablation, atrial fibrillation ablation requires greater technical skill, significantly more lesions, and time. Like many other medical procedures, technological innovation is likely to be a contributing factor in making atrial fibrillation ablation a more commonplace and widely practiced therapy.Navigating the complex anatomy of the left atrium is also difficult to master. Imaging technologies have been used to orient the operator to the anatomy and the location of the ablation catheters in this anatomy. With fluoroscopy alone, it is difficult to determine anterior versus posterior orientation or the presence of the catheter in a pulmonary vein versus the left atrial appendage. Intracardiac echocardiography (ICE) provides 2-dimensional navigation assistance and excellent anatomic detail; however, it is difficult to locate the catheter tip at all times in the echocardiography field. Without 3-dimensional (3D) imaging, navigation with ICE alone is also difficult. Electroanatomic mapping (EAM) systems offer a 3D view and nearly real-time catheter tip localization within a created construct of the left atrium, but the data are heavily dependent on the input of the operator and cartographer. Newer technology has merged these 2 imaging modalities to offer the best of both worlds.Remotely obtained computed tomography (CT) imaging of the left atrium has been performed to define the complex anatomy of the left atrium. This can be integrated into EAMs or imaging systems to aid in navigation and procedure planning. However, conditions at the time of CT may be different from those at the time of a...

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View-Synchronized Robotic Image-Guided Therapy for Atrial Fibrillation Ablation

Cited by 90 publications

References 20 publications

A New Design of Two-Fingered Catheter Operating Robot for Vascular Interventional Surgery

A New Design of Two-Fingered Catheter Operating Robot for Vascular Interventional Surgery

New Ablation Technologies and Techniques

New Technologies in Atrial Fibrillation Ablation

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