Bayesian Optimization Based Preprocedural Planning For Robotic Left Atrial Appendage Occlusion.

Abstract

Left atrial appendage occlusion is a procedure to reduce the risk of thromboembolism in atrial fibrillation patients by blocking the left atrial appendage ostium using an occlusion device implanted by an intra-vascular delivery catheter. The preprocedural planning of the left atrial appendage occlusion procedure aims to identify an optimal implantation trajectory for a successful occlusion implant delivery from a structural understanding of the left atrial appendage. In this paper, a Bayesian Optimization based preprocedural planning approach is proposed for the robotic left atrial appendage occlusion procedure. The preprocedural planner efficiently samples transseptal puncture positions over the fossa ovalis and sequentially optimizes the transseptal puncture location. The iterative linear-quadratic-regulator is employed by the Bayesian Optimization planner for locally optimizing the occlusion trajectory for a given transseptal puncture location. The performance of the proposed Bayesian Optimization based preprocedural planner is evaluated in a simulation environment using a real cardiac anatomy model.