Why the study?
Recent progress in ablation therapy for atrial fibrillation and ventricular tachycardia leverages MRI for visual feedback and actively deflectable guiding sheaths to improve catheter dexterity, prompting the need for compatible automated actuation.
The newly designed MR-conditional robotic module for catheter actuation demonstrated high precision with < 2 mm tip position error, potentially improving MRI-guided ablation for arrhythmias.
Extends preclinical evidence for MR-conditional robotic precision; leaves open clinical translation to MRI-guided ablation.
Atrial fibrillation (AF) and ventricular tachycar-dia (VT) are two of the sustained arrhythmias that significantly affect the quality of life of patients. Treatment of AF and VT often requires radiofrequency ablation of heart tissues using an ablation catheter. Recent progress in ablation therapy leverages magnetic resonance imaging (MRI) for higher contrast visual feedback, and additionally utilizes a guiding sheath with an actively deflectable tip to improve the dexterity of catheter ma-nipulation inside the heart. This paper presents the design and validation of an MR-conditional robotic module for automated 6-degrees-of-freedom actuation of both the ablation catheter and the sheath. The robotic module features a compact design for improved accessibility inside the MR scanner bore and is driven by piezoelectric motors to ensure MR-conditionality. The combined catheter-sheath mechanism is essentially a concentric tendon-driven continuum robot and its kinematics is modeled by the constant curvature model for closed-loop position control. Path following experiments were conducted to validate the actuation module and control scheme, achieving < 2 mm average tip position error with closed-loop control and online shape fitting.
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Wang et al. (2024) studied this question.
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