Robotic catheter cardiac ablation combining ultrasound guidance and force control. (April 2014)

• Record Type: Journal Article
• Authors: Kesner, Samuel B.; Howe, Robert D.
• Is Part Of: International journal of robotics research. Volume 33:Number 4(2014:Apr.)
• Page Start: 631
• Page End: 644
• Publication Date: 2014-04
• Subjects: Medical robotics -- heart surgery -- force control -- catheter robot -- ablation; Robots -- Periodicals; Robots, Industrial -- Periodicals; 629.89205
• DOI: 10.1177/0278364913511350
• Languages: English
• ISSNs: 0278-3649

Abstract

Cardiac catheters allow physicians to access the inside of the heart and perform therapeutic interventions without stopping the heart or opening the chest. However, conventional manual and actuated cardiac catheters are currently unable to precisely track and manipulate the intracardiac tissue structures because of the fast tissue motion and potential for applying damaging forces. This paper addresses these challenges by proposing and implementing a robotic catheter system that uses 3D ultrasound image guidance and force control to enable constant contact with a moving target surface in order to perform interventional procedures, such as intracardiac tissue ablation. The robotic catheter system, consisting of a catheter module, ablation and force sensing end effector, drive system, and image-guidance and control system, was commanded to apply a constant force against a moving target using a position-modulated force control method. The control system uses a combination of position tracking, force feedback, and friction and backlash compensation to achieve accurate and safe catheter–tissue interactions. The catheter was able to maintain a 1 N force on a moving motion simulator target under ultrasound guidance with 0.08 N RMS error. In a simulated ablation experiment, the robotic catheter was also able to apply a consistent force on the target while maintaining ablation electrode contact with 97% less RMS contact resistance variation than a passive mechanical equivalent. In addition, the use of force control improved catheter motion tracking by approximately 20%. These results demonstrate that 3D ultrasound guidance and force tracking allow the robotic system to maintain improved contact with a moving tissue structure, thus allowing for more accurate and repeatable cardiac procedures.