Automated Catheter Tip Repositioning for Intra-cardiac Echocardiography

TL;DR

This paper presents a robotic control system for intra-cardiac echocardiography that automates catheter tip repositioning, enabling precise view recovery and potentially reducing procedure time, labor, and radiation exposure.

Contribution

The study introduces an automated catheter tip repositioning method for ICE, demonstrating high accuracy in phantom and animal experiments, and enabling fluoro-less procedures.

Findings

Achieved catheter position accuracy of ~2 mm in animals.

Successfully used during animal transeptal puncture without complications.

Reduced need for fluoroscopy in cardiac procedures.

Abstract

Purpose: Intra-Cardiac Echocardiography (ICE) is a powerful imaging modality for guiding cardiac electrophysiology and structural heart interventions. ICE provides real-time observation of anatomy and devices, while enabling direct monitoring of potential complications. In single operator settings, the physician needs to switch back-and-forth between the ICE catheter and therapy device, making continuous ICE support impossible. Two operators setup are therefore sometimes implemented, with the challenge of increase room occupation and cost. Two operator setups are sometimes implemented, but increase procedural costs and room occupation. Methods: ICE catheter robotic control system is developed with automated catheter tip repositioning (i.e. view recovery) method, which can reproduce important views previously navigated to and saved by the user. The performance of the proposed method is demonstrated and evaluated in a combination of heart phantom and animal experiments. Results: Automated ICE view recovery achieved catheter tip position accuracy of 2.09 +/-0.90 mm and catheter image orientation accuracy of 3.93 +/- 2.07 degree in animal studies, and 0.67 +/- 0.79 mm and 0.37 +/- 0.19 degree in heart phantom studies, respectively. Our proposed method is also successfully used during transeptal puncture in animals without complications, showing the possibility for fluoro-less transeptal puncture with ICE catheter robot. Conclusion: Robotic ICE imaging has the potential to provide precise and reproducible anatomical views, which can reduce overall execution time, labor burden of procedures, and x-ray usage for a range of cardiac procedures. Keywords: Automated View Recovery, Path Planning, Intra-cardiac echocardiography (ICE), Catheter, Tendon-driven manipulator, Cardiac Imaging