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Optimal Transseptal Puncture Location for Robot Assisted Left Atrial Catheter Ablation

Institution:	1Surgical Planning Laboratory, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 2Canadian Surgical Technologies and Advanced Robotics, The University of Western Ontario, London, ON N6A 5B9, Canada 3Department of Cardiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02215
Publisher:	Int Conf Med Image Comput Comput Assist Interv. MICCAI 2009
Publication Date:	Sep-2009
Citation:	Int Conf Med Image Comput Comput Assist Interv. 2009;12(Pt 1):1-8.
Keywords:	Cardiac Ablation, Transseptal Puncture, Global Isotropy Index, Dexterity, Continuum Robot Model
Appears in Collections:	SNR, SLICER, SPL
Sponsors:	New Energy and Industrial Technology Development Organization, Japan
Generated Citation:	Jayender J, Patel R, Michaud G, Hata N. Optimal Transseptal Puncture Location for Robot Assisted Left Atrial Catheter Ablation. Int Conf Med Image Comput Comput Assist Interv. 2009;12(Pt 1):1-8.
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The preferred method of treatment for Atrial Fibrillation (AF) is by catheter ablation wherein a catheter is guided into the left atrium through a transseptal puncture. However, the transseptal puncture constrains the catheter, thereby limiting its maneuverability and increasing the difficulty in reaching various locations in the left atrium. In this paper, we address the problem of choosing the optimal transseptal puncture location for performing cardiac ablation to obtain maximum maneuverability of the catheter. We have employed an optimization algorithm to maximize the Global Isotropy Index (GII) to evaluate the optimal transseptal puncture location. As part of this algorithm, a novel kinematic model for the catheter has been developed based on a continuum robot model. Preoperative MR/CT images of the heart are segmented using the open source image-guided therapy software, Slicer 3, to obtain models of the left atrium and septal wall. These models are input to the optimization algorithm to evaluate the optimal transseptal puncture location. Simulation results for the optimization algorithm are presented in this paper.

Jagadeesan-MICCAI2009-fig1.jpg (40.654kB)