Dataset Information

Autonomous Robotic Intracardiac Catheter Navigation Using Haptic Vision.

ABSTRACT: While all minimally invasive procedures involve navigating from a small incision in the skin to the site of the intervention, it has not been previously demonstrated how this can be done autonomously. To show that autonomous navigation is possible, we investigated it in the hardest place to do it - inside the beating heart. We created a robotic catheter that can navigate through the blood-filled heart using wall-following algorithms inspired by positively thigmotactic animals. The catheter employs haptic vision, a hybrid sense using imaging for both touch-based surface identification and force sensing, to accomplish wall following inside the blood-filled heart. Through in vivo animal experiments, we demonstrate that the performance of an autonomously-controlled robotic catheter rivals that of an experienced clinician. Autonomous navigation is a fundamental capability on which more sophisticated levels of autonomy can be built, e.g., to perform a procedure. Similar to the role of automation in fighter aircraft, such capabilities can free the clinician to focus on the most critical aspects of the procedure while providing precise and repeatable tool motions independent of operator experience and fatigue.

SUBMITTER: Fagogenis G

PROVIDER: S-EPMC6693882 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Autonomous Robotic Intracardiac Catheter Navigation Using Haptic Vision.

Fagogenis G G Mencattelli M M Machaidze Z Z Rosa B B Price K K Wu F F Weixler V V Saeed M M Mayer J E JE Dupont P E PE

Science robotics 20190401 29

While all minimally invasive procedures involve navigating from a small incision in the skin to the site of the intervention, it has not been previously demonstrated how this can be done autonomously. To show that autonomous navigation is possible, we investigated it in the hardest place to do it - inside the beating heart. We created a robotic catheter that can navigate through the blood-filled heart using wall-following algorithms inspired by positively thigmotactic animals. The catheter emplo ...[more]

PMID: 31414071

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Project description:BackgroundA new zero-fluoroscopy technique for electrophysiology catheter navigation relying on intracardiac echocardiography (ICE) has been recently reported (Ice&ICE trial). We investigated potential differences in efficacy, safety or procedural performance between conventional fluoroscopy- and ICE-guided cryothermal ablation (CA) in symptomatic AVNRT patients.MethodsClinical and electrophysiological data of AVNRT patients included in the Ice&ICE trial (22 patients, 16 females; =zero-fluoroscopy group) were compared to those of consecutive AVNRT patients, who underwent fluoroscopy-guided CA (25 patients, 17 females; = fluoroscopy group) during the last 2 years in our institution.ResultsSlow pathway ablation or modulation was successful in all patients. Fluoroscopy time and radiation dose in the fluoroscopy group were 11.2?±?9.0?min and 20.3?±?16.2Gycm2, whereas no fluoroscopy was used in the opposite group (p <? 0.001, respectively). EPS duration was not different between the groups (zero-fluoroscopy:101.6?±?40.2?min, fluoroscopy:99.4?±?37.2?min, p =?n.s.). Catheter placement time was significantly shorter in the fluoroscopy group (2.2?±?1.6?min vs. 12.0?±?7.5?min, p <? 0.05), whereas cryo-application duration (from the first cryo-mapping to the last CA) was significantly shorter in the zero-fluoroscopy group (27.5?±?37.0?min vs. 38.1?±?33.9?min, p <? 0.05). Mean cryo-mapping and CA applications were numerically lower in the zero-fluoroscopy group (CM:7.5?±?5.7 vs. 8.8?±?6.2; CA:3.1?±?1.7 vs. 3.2?±?2.0, p =?n.s.). No major adverse events occurred in both groups. After 15.0?±?4.2?months, arrhythmia recurrence was not different between the groups (4.5% vs. 8.0%, p =?n.s.).ConclusionsZero-fluoroscopy ICE-guided EP catheter navigation shows comparable efficacy and safety to fluoroscopic guidance during CA in AVNRT patients. ICE visualization of catheters and endocardial structures within the triangle of Koch shortens the cryo-application duration, though time needed for catheter placement is longer, when compared with conventional fluoroscopic guidance, which results in similar mean EPS duration with both navigation techniques.Trial registration(German Clinical Trials Register ID: DRKS00011360 ; Registration Date 14.12.2016).

Dataset Information

Autonomous Robotic Intracardiac Catheter Navigation Using Haptic Vision.

Publications

Autonomous Robotic Intracardiac Catheter Navigation Using Haptic Vision.

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