Real-Time Contact Force Measurement

Shah, Dipen; Namdar, Mehdi

doi:10.1161/circep.115.002779

Cited by 36 publications

(14 citation statements)

References 45 publications

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“…11(a). According to (Shah & Namdar, 2015), force amplitude of under 196.13 mN (20 g) are indicative of instable contact. Moreover, the curves in Fig.…”

Section: Patient Datamentioning

confidence: 99%

“…Contact force has become a measure of catheter stability and the force-time integral an estimation of the lesion quality. However, Shah & Namdar (2015) were among the first to acknowledge the possibility of catheter tip sliding under consistent ampli-60 tude of the contact force, which they defined as spatial instability. The authors distinguished between spatial stability, quantified by the sliding distance, and temporal stability, measured by contact force amplitude and force-time integral, concluding that force amplitude information alone was not a measure of good contact.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Probabilistic guidance for catheter tip motion in cardiac ablation procedures

Constantinescu

Su-Lin

Ernst

et al. 2018

Medical Image Analysis

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Radiofrequency catheter ablation is one of the commonly available therapeutic methods for patients suffering from cardiac arrhythmias. The prerequisite of successful ablation is sufficient energy delivery at the target site. However, cardiac and respiratory motion, coupled with endocardial irregularities, can cause catheter drift and dispersion of the radiofrequency energy, thus prolonging procedure time, damaging adjacent tissue, and leading to electrical reconnection of temporarily ablated regions. Therefore, positional accuracy and stability of the catheter tip during energy delivery is of great importance for the outcome of the procedure. This paper presents an analytical scheme for assessing catheter tip stability, whereby a sequence of catheter tip motion recorded at sparse locations on the endocardium is decomposed. The spatial sliding component along the endocardial wall is extracted from the recording and maximal slippage and its associated probability are computed at each mapping point. Finally, a global map is generated, allowing the assessment of potential areas that are compromised by tip slippage. The proposed framework was applied to 40 retrospective studies of congenital heart disease patients and further validated on phantom data and simulations. The results show a good correlation with other intraoperative factors, such as catheter tip contact force amplitude and orientation, and with clinically documented anatomical areas of high catheter tip instability.

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“…11(a). According to (Shah & Namdar, 2015), force amplitude of under 196.13 mN (20 g) are indicative of instable contact. Moreover, the curves in Fig.…”

Section: Patient Datamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Probabilistic guidance for catheter tip motion in cardiac ablation procedures

Constantinescu

Su-Lin

Ernst

et al. 2018

Medical Image Analysis

View full text Add to dashboard Cite

show abstract

“…20 Catheter contact stability is important and can be considered to be a combination of both temporal contact stability (which refers to degree of contact variation over time) and spatial contact stability (which refers to stability in terms of spatial localisation with respect to the endocardium). 21 Realtime CF monitoring is crucial in achieving temporal stability, and by implication, transmurality, whereas accurate 3D localisation with respect to the endocardium is necessary for achieving spatial contact stability (as opposed to a fixed extracardiac/extrathoracic reference, which is currently the state of the art), which is crucial for individual lesion localisation and therefore multi-lesion contiguity. 21 There are, however, other parameters beyond catheter tissue contact which are important in determining RF lesion size and contiguity.…”

Section: Optimising Contact Forcementioning

confidence: 99%

“…21 Realtime CF monitoring is crucial in achieving temporal stability, and by implication, transmurality, whereas accurate 3D localisation with respect to the endocardium is necessary for achieving spatial contact stability (as opposed to a fixed extracardiac/extrathoracic reference, which is currently the state of the art), which is crucial for individual lesion localisation and therefore multi-lesion contiguity. 21 There are, however, other parameters beyond catheter tissue contact which are important in determining RF lesion size and contiguity. …”

Section: Optimising Contact Forcementioning

confidence: 99%

Evolution of Force Sensing Technologies

Shah

2017

Arrhythmia &Amp; Electrophysiology Review

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In order to improve the procedural success and long-term outcomes of catheter ablation techniques for atrial fibrillation (AF), an important unfulfilled requirement is to create durable electrophysiologically complete lesions. Measurement of contact force (CF) between the catheter tip and the target tissue can guide physicians to optimise both mapping and ablation procedures. Contact force can affect lesion size and clinical outcomes following catheter ablation of AF. Force sensing technologies have matured since their advent several years ago, and now allow the direct measurement of CF between the catheter tip and the target myocardium in real time. In order to obtain complete durable lesions, catheter tip spatial stability and stable contact force are important. Suboptimal energy delivery, lesion density/ contiguity and/or excessive wall thickness of the pulmonary vein-left atrial (PV-LA) junction may result in conduction recovery at these sites. Lesion assessment tools may help predict and localise electrical weak points resulting in conduction recovery during and after ablation. There is increasing clinical evidence to show that optimal use of CF sensing during ablation can reduce acute PV re-conduction, although prospective randomised studies are desirable to confirm long-term favourable clinical outcomes. In combination with optimised lesion assessment tools, contact force sensing technology has the potential to become the standard of care for all patients undergoing AF catheter ablation.

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“…28 To mitigate for risk, contact force sensors should be appropriately zeroed and re-zeroed after every reintroduction into the vascular system or through a sheath. It should be kept in mind that electromagnetic interference is likely to reduce the accuracy of this form of CF sensing.…”

Section: Relevance Of Fire and Icementioning

confidence: 99%

16th Atrial Fibrillation Symposium

Wasek¹

2017

Arrhythmia &Amp; Electrophysiology Review

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A trial fibrillation (AF) currently affects 2 % of the population, with estimates that by 2030, 14-17 million people in Europe will experience AF. 1 This debilitating condition is fast becoming a critical public health issue. To improve education and care in this area, Biosense Webster has developed ground-breaking innovations and has sponsored this educational symposium for 16years. This year's symposium took place on 22-24 March 2017 in The Hague, the Netherlands, and welcomed an international faculty to present an agenda that reflected the newest developments, research and perspectives in AF treatment.The Atrial Fibrillation Practical Sessions were conducted on the first day and focused on all aspects of the AF ablation procedure and the practical usage of new technologies in the field of AF ablation. The high-level lectures were case-based and geared towards improving procedure workflow and, ultimately, improving patient care. International expert faculty shared experiences from their practice, as well as tips and tricks. The target audience was physicians looking to perfect their procedure workflows, enhancing efficacy, efficiency and safety through the sharing of knowledge.The next two days comprised the Atrial Fibrillation Symposium, where international faculties presented the newest developments and research results, some prior to publication. The target audience was skilled AF practitioners seeking the most progressive information in this field to advance their knowledge and practice. Interactive polling via handheld devices provided real-time insights, in addition to engagement through Q&A sessions during each panel discussion. Attendees received up to 10 hours of CME for their participation.In welcoming attendees to the 16th Atrial Fibrillation Symposium, Prof Dipen Shah of Geneva, Switzerland, said: "This year's programme has been put together to emphasise currently relevant themes and threads in the field of AF and its treatment by catheter ablation. Although AF has an undeniably characteristic electrical signature, the increasing awareness and understanding of causative sequelae and associated structural abnormalities in the atria have led to the acknowledgement of atrial cardiomyopathy as a distinct entity. The symposium's scientific intent will therefore kick off with an exposition of this. It is my sincere hope that you will enjoy the proceedings as much as I and my colleagues in the scientific committee did putting the programme together."Prof Dipen Shah giving the welcome to symposium attendees.

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Real-Time Contact Force Measurement

Cited by 36 publications

References 45 publications

Probabilistic guidance for catheter tip motion in cardiac ablation procedures

Probabilistic guidance for catheter tip motion in cardiac ablation procedures

Evolution of Force Sensing Technologies

16th Atrial Fibrillation Symposium

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