The manoeuvring of electrophysiology (EP) catheters in the heart is carried out manually by an operator, at the patient’s side, aided by X-ray fluoroscopy. Remote manipulation of EP catheters by means of a magnetically-guided or a robotically controlled navigation system has been recently proposed; however, these systems could be expensive, cumbersome and can require dedicated catheters and devices. This study aims at evaluating the feasibility of using a novel Telerobotic System (TS) to remotely manipulate standard steerable EP catheters. The TS is an electromechanical device which allows the operator to remotely control the catheter movements from a X-ray shielded workstation. In order to prevent cardiac tissue damage, the TS was equipped with a force sensor, which measures the resistance encountered by the catheter while advancing. The use of the novel TS was evaluated in three sheep. A standard EP catheter was remotely navigated by the TS to two selected catheter-endocardium contact targeted sites in the Right Atrium (RA); automatic catheter repositioning to these two targets was subsequently performed, by using the TS. The force signal (F) and the impedance (Z) from the EP catheter electrodes were continuously recorded. For each targeted sites, percent variations of F (ΔF), relatively to a reference non-contact catheter-endocardium position in the RA, were compared with percent variations of Z (ΔZ). Remote catheter navigation by means of the TS was achieved for all targets. F signal showed to provide reliable information about catheter advancing and indication about catheter-endocardium contact, while Z measurements were less sensitive (ΔF=216%, 222%, 150%, against ΔZ=4%, 103%, 75%, for sheep 1, 2, 3, respectively). The TS, equipped with an on-board force sensor, proved to be a promising tool for safe remote navigation of standard steerable EP catheters. Further studies will be required to confirm these initial encouraging results.
Feasibility and safety of remote endocardial catheter navigation with a novel robotic system: early animal experience / E. Marcelli; L. Cercenelli; G. Plicchi. - STAMPA. - (2008), pp. 805-806. (Intervento presentato al convegno Congresso Nazionale di Bioingegneria tenutosi a Pisa nel 03-05/07/2008).
Feasibility and safety of remote endocardial catheter navigation with a novel robotic system: early animal experience
MARCELLI, EMANUELA;CERCENELLI, LAURA;PLICCHI, GIANNI
2008
Abstract
The manoeuvring of electrophysiology (EP) catheters in the heart is carried out manually by an operator, at the patient’s side, aided by X-ray fluoroscopy. Remote manipulation of EP catheters by means of a magnetically-guided or a robotically controlled navigation system has been recently proposed; however, these systems could be expensive, cumbersome and can require dedicated catheters and devices. This study aims at evaluating the feasibility of using a novel Telerobotic System (TS) to remotely manipulate standard steerable EP catheters. The TS is an electromechanical device which allows the operator to remotely control the catheter movements from a X-ray shielded workstation. In order to prevent cardiac tissue damage, the TS was equipped with a force sensor, which measures the resistance encountered by the catheter while advancing. The use of the novel TS was evaluated in three sheep. A standard EP catheter was remotely navigated by the TS to two selected catheter-endocardium contact targeted sites in the Right Atrium (RA); automatic catheter repositioning to these two targets was subsequently performed, by using the TS. The force signal (F) and the impedance (Z) from the EP catheter electrodes were continuously recorded. For each targeted sites, percent variations of F (ΔF), relatively to a reference non-contact catheter-endocardium position in the RA, were compared with percent variations of Z (ΔZ). Remote catheter navigation by means of the TS was achieved for all targets. F signal showed to provide reliable information about catheter advancing and indication about catheter-endocardium contact, while Z measurements were less sensitive (ΔF=216%, 222%, 150%, against ΔZ=4%, 103%, 75%, for sheep 1, 2, 3, respectively). The TS, equipped with an on-board force sensor, proved to be a promising tool for safe remote navigation of standard steerable EP catheters. Further studies will be required to confirm these initial encouraging results.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
