I-Corps Teams: Magnetic Resonance Imaging Guided Active Robotic Catheter

Case Western Reserve University, Cleveland OH

Investigators

Abstract

Catheter-based atrial fibrillation (AF) ablation is a minimally invasive technique used in the treatment of AF. In this procedure, a catheter under fluoroscopy guidance is used to apply radiofrequency energy to build ablation barriers in the left atrium to prevent the spread of the irregular electrical signals, which cause the arrhythmia. The major problems with the state-of-the-art AF ablation procedure entail creating too small or too large of a lesion. These result from difficulties in accurately controlling the catheter tip, difficulties in keeping appropriate electrode contact pressure with the endocardium, and lack of real-time feedback regarding the size and depth of the lesion created. The proposed real-time magnetic resonance imaging-guided robotic active catheter technology has the potential to revolutionize the treatment AF by significantly improving the accuracy and repeatability of AF ablation therapy, and by potentially reducing the cost of the procedure. The proposed paradigm has several advantages over the state-of-the-art techniques and technologies for cardiac ablation therapy, as it would allow a more tailored treatment to be performed. Specifically, intra-operative real-time availability of magnetic resonance imaging, with its superior tissue discrimination capabilities, would allow immediate evaluation of the substrate depth and lesion created by ablation. Remote steering and high accuracy catheter tip position control would allow for precise ablation. The operator would have improved situational awareness, as the intra-operative information, including the electrophysiological map, catheter trajectories, and tissue measurements obtained from real-time magnetic resonance imaging, can be mapped back and displayed to the operating physician on the 3D static reference visualization of the cardiac anatomy. And, finally, the patient will not be exposed to ionizing radiation during the procedure, as fluoroscopy will not be used. If the commercialization feasibility study performed through the I-Corps program yields a positive result, the team is planning to establish a start-up company that will license the technology from Case Western Reserve University and pursue its commercialization.