Jacob Miller, Alykhan Sewani, Jeffrey Rezazada, Yara Alawneh, Pedram Kazemian, Maria Terricabras, Graham Wright, M Ali Tavallaei
{"title":"应用心脏幻影治疗心房颤动的常规可操纵消融导管的力学特性量化。","authors":"Jacob Miller, Alykhan Sewani, Jeffrey Rezazada, Yara Alawneh, Pedram Kazemian, Maria Terricabras, Graham Wright, M Ali Tavallaei","doi":"10.1007/s13239-023-00662-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Accurate and reliable catheter navigation is important in formation of adequate lesions during radiofrequency cardiac catheter ablation. To inform future device design efforts and to characterize the limitations of conventional devices, the focus of this study is to assess and quantify the mechanical performance of manual ablation catheters for pulmonary vein isolation procedures within a phantom heart model.</p><p><strong>Methods: </strong>We measured three important metrics: accuracy of catheter tip navigation to target anatomical landmarks at the pulmonary veins (PVs), orientation of the catheter relative to the tissue at the targets, and the delivered force values and their stability and variations at those targets. A stereovision system was used for navigational guidance and to measure the catheter's tip position and orientation relative to the targets. To measure force, piezoelectric sensors were used which were integrated at the targets, whereby operators were instructed to stabilize the catheter to achieve a chosen reference force value.</p><p><strong>Results: </strong>An overall positioning accuracy of 1.57 ± 1.71 mm was achieved for all targets. No statistical significance was observed in position accuracy between the right and left PVs (p = 0.5138). The orientation of the catheter relative to tissue surface was 41° ± 21° with no statistical significance between targets. The overall force stability was 41 ± 6 g with higher difficulty in force stabilization in the right compared to the left PV (40 ± 8 vs. 43 ± 2 g, p < 0.0001).</p><p><strong>Conclusion: </strong>Based on our results, future improvements to manual catheter navigation for ablation should focus on improving device performance in orientation control and improved force stability.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Quantification of Mechanical Characteristics of Conventional Steerable Ablation Catheters for Treatment of Atrial Fibrillation Using a Heart Phantom.\",\"authors\":\"Jacob Miller, Alykhan Sewani, Jeffrey Rezazada, Yara Alawneh, Pedram Kazemian, Maria Terricabras, Graham Wright, M Ali Tavallaei\",\"doi\":\"10.1007/s13239-023-00662-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Accurate and reliable catheter navigation is important in formation of adequate lesions during radiofrequency cardiac catheter ablation. To inform future device design efforts and to characterize the limitations of conventional devices, the focus of this study is to assess and quantify the mechanical performance of manual ablation catheters for pulmonary vein isolation procedures within a phantom heart model.</p><p><strong>Methods: </strong>We measured three important metrics: accuracy of catheter tip navigation to target anatomical landmarks at the pulmonary veins (PVs), orientation of the catheter relative to the tissue at the targets, and the delivered force values and their stability and variations at those targets. A stereovision system was used for navigational guidance and to measure the catheter's tip position and orientation relative to the targets. To measure force, piezoelectric sensors were used which were integrated at the targets, whereby operators were instructed to stabilize the catheter to achieve a chosen reference force value.</p><p><strong>Results: </strong>An overall positioning accuracy of 1.57 ± 1.71 mm was achieved for all targets. No statistical significance was observed in position accuracy between the right and left PVs (p = 0.5138). The orientation of the catheter relative to tissue surface was 41° ± 21° with no statistical significance between targets. The overall force stability was 41 ± 6 g with higher difficulty in force stabilization in the right compared to the left PV (40 ± 8 vs. 43 ± 2 g, p < 0.0001).</p><p><strong>Conclusion: </strong>Based on our results, future improvements to manual catheter navigation for ablation should focus on improving device performance in orientation control and improved force stability.</p>\",\"PeriodicalId\":54322,\"journal\":{\"name\":\"Cardiovascular Engineering and Technology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Engineering and Technology\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1007/s13239-023-00662-6\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Engineering and Technology","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s13239-023-00662-6","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 1
摘要
目的:在心脏导管射频消融术中,准确可靠的导管导航对形成足够的病灶至关重要。为了为未来的设备设计工作提供信息,并描述传统设备的局限性,本研究的重点是评估和量化用于肺静脉隔离手术的人工消融导管在模拟心脏模型中的机械性能。方法:我们测量了三个重要指标:导管尖端导航到肺静脉(pv)目标解剖标志的准确性,导管相对于目标组织的方向,以及在这些目标上传递的力值及其稳定性和变化。立体视觉系统用于导航引导和测量导管尖端相对于目标的位置和方向。为了测量力,使用集成在目标上的压电传感器,指示操作员稳定导管以达到选定的参考力值。结果:所有目标的总体定位精度为1.57±1.71 mm。左右pv的定位精度差异无统计学意义(p = 0.5138)。导管相对于组织表面的方向为41°±21°,靶间差异无统计学意义。整体力稳定性为41±6 g,与左侧PV相比,右侧PV的力稳定难度更高(40±8 vs. 43±2 g)。结论:基于我们的研究结果,未来手动导管导航消融的改进应集中在改善装置的方向控制性能和改善力稳定性上。
Quantification of Mechanical Characteristics of Conventional Steerable Ablation Catheters for Treatment of Atrial Fibrillation Using a Heart Phantom.
Purpose: Accurate and reliable catheter navigation is important in formation of adequate lesions during radiofrequency cardiac catheter ablation. To inform future device design efforts and to characterize the limitations of conventional devices, the focus of this study is to assess and quantify the mechanical performance of manual ablation catheters for pulmonary vein isolation procedures within a phantom heart model.
Methods: We measured three important metrics: accuracy of catheter tip navigation to target anatomical landmarks at the pulmonary veins (PVs), orientation of the catheter relative to the tissue at the targets, and the delivered force values and their stability and variations at those targets. A stereovision system was used for navigational guidance and to measure the catheter's tip position and orientation relative to the targets. To measure force, piezoelectric sensors were used which were integrated at the targets, whereby operators were instructed to stabilize the catheter to achieve a chosen reference force value.
Results: An overall positioning accuracy of 1.57 ± 1.71 mm was achieved for all targets. No statistical significance was observed in position accuracy between the right and left PVs (p = 0.5138). The orientation of the catheter relative to tissue surface was 41° ± 21° with no statistical significance between targets. The overall force stability was 41 ± 6 g with higher difficulty in force stabilization in the right compared to the left PV (40 ± 8 vs. 43 ± 2 g, p < 0.0001).
Conclusion: Based on our results, future improvements to manual catheter navigation for ablation should focus on improving device performance in orientation control and improved force stability.
期刊介绍:
Cardiovascular Engineering and Technology is a journal publishing the spectrum of basic to translational research in all aspects of cardiovascular physiology and medical treatment. It is the forum for academic and industrial investigators to disseminate research that utilizes engineering principles and methods to advance fundamental knowledge and technological solutions related to the cardiovascular system. Manuscripts spanning from subcellular to systems level topics are invited, including but not limited to implantable medical devices, hemodynamics and tissue biomechanics, functional imaging, surgical devices, electrophysiology, tissue engineering and regenerative medicine, diagnostic instruments, transport and delivery of biologics, and sensors. In addition to manuscripts describing the original publication of research, manuscripts reviewing developments in these topics or their state-of-art are also invited.