Design of a Robotic Catheterization Platform With Use of Commercial Ablation Catheter

Cardiovascular diseases including atherosclerosis, thrombosis, aneurysm and arrhythmia remain the major cause of mortality in developed countries, accounting for 34% of deaths each year [1]. Commonly used minimally invasive vascular intervention with using catheters leads to higher success rate than open surgery [2]. Integrating robotic technologies into active control of catheters in teleoperation manner has promised to reduce radiation exposure to surgeons and improve accuracy during electro-physiological (EP) procedures [1]. Common used commercial robotic EP catheter platforms such as Sensei (Hansen Medical Inc., USA) and Niobe (Stereotaxis Inc., USA) are usually composed of a catheter driver (slave side) which can be remotely controlled by a console operator (master side). However, the Sensei catheters are more rigid and bigger than standard catheters because of their two-layer-sheath structure; and Magnetic Niobe systems are huge and expensive. In this paper, we propose a mechanism of remote-driving catheterization platforms in which a commercial tip-steerable ablation catheter (St. Jude Medical Inc., USA) (Fig. 1) is manipulated by a catheter driver in three degree of freedoms (DOF) (insertion/withdrawal, rotation and tip deflection). In addition, we also present the design of the control software based on Object-Oriented Programming (OOP) method which is expected to give the other researchers a guide line during robotic catheter design.

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Effects of Open-Irrigated Radiofrequency Ablation Catheter Design on Lesion Formation and Complications: In Vitro Comparison of 6 Different Devices

Journal of Cardiovascular Electrophysiology ◽

10.1111/jce.12175 ◽

2013 ◽

Vol 24 (10) ◽

pp. 1157-1162 ◽

Cited By ~ 14

Author(s):

JOSE M. GUERRA ◽

ESTHER JORGE ◽

SILVIA RAGA ◽

CAROLINA GÁLVEZ-MONTÓN ◽

CONCEPCIÓN ALONSO-MARTÍN ◽

...

Keyword(s):

Radiofrequency Ablation ◽

Ablation Catheter ◽

Lesion Formation ◽

Catheter Design ◽

In Vitro Comparison

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P2842Sequential application of horizontal and vertical orientation on radiofrequency ablation lesions produced by thermocool smarttouch SF catheter

European Heart Journal ◽

10.1093/eurheartj/ehz748.1152 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

K Morgaenko ◽

S Noshin ◽

W Stevenson ◽

N Mehta

Keyword(s):

Radiofrequency Ablation ◽

Surface Area ◽

Lesion Size ◽

Ablation Catheter ◽

Vertical Orientation ◽

Lesion Depth ◽

Catheter Design ◽

Significant Difference ◽

The Impact ◽

Area And Volume

Abstract Background Ablation lesions represent a complex interaction between the ablation catheter configuration and tissue anatomy. An understanding of each variable can assist in determination of the optimal lesion set. One such variable is the catheter orientation. With an irrigated radiofrequency ablation catheter with 6 pores (6P) near the distal tip, lesion surface area and volumes are smaller in the horizontal catheter orientation compared to the vertical catheter orientation. This finding is explained by the 6P irrigation catheter design, where irrigation fluid is discharged from six ports around the circumference of the electrode. Introduced in 2015, the ThermoCool SmartTouch® SF catheter has a 56-pore (56P) distribution to provide high density low volume irrigation settings. Irrigation catheters create smaller lesions in horizontal orientation compared to vertical orientation, however this has not been studied for the 56P irrigated catheter. Purpose Evaluate the impact of catheter orientation with sequential application of 56P catheter. Methods Ablation lesions were created on additive-free chicken model in a saline bath heated to 37°C using the 56P catheter under standard flow rate (8cc/min) conditions. Ablation energy of 20W and 30W was delivered twice for 30 seconds with 3 minutes interval between applications. Contact force (CF) of 5, 10, 15, and 20g was applied with the following conditions: horizontal catheter orientation followed by horizontal (HH), vertical by vertical (VV), horizontal by vertical (HV), and vertical by horizontal catheter orientation (VH). Measurements were obtained by lesion dissection through the midpoint by 3 independent operators. Kruskal-Wallis test was used for comparison of lesion depth, surface area and volume. Results Ninety-six lesions were analyzed. No coagulum or steam pops were included in the analysis. The minimum and maximum lesion depth, surface area and volume were 1.5 & 6.0 mm, 14.1 & 117.7mm2, 47.1 & 471.0 mm3 respectively. There was no significant difference in the lesion depth, surface area or volume in HH, VV, HV or VH orientation at different CF with 20W and 30W. (Fig 1) Figure 1 Conclusion Unlike other irrigated catheters, catheter orientation with sequential application with different CF and power did not impact lesion depth, surface area and volume with 56P catheter. This finding could be considered useful in situations where the catheter orientation could be challenging owing to tissue anatomy to achieve adequate lesion size. Acknowledgement/Funding UVA Health System

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A 3-Dimensional In Silico Test Bed for Radiofrequency Ablation Catheter Design Evaluation and Optimization

10.15368/theses.2019.57 ◽

2019 ◽

Author(s):

Carolyn Teng

Keyword(s):

Radiofrequency Ablation ◽

In Silico ◽

Design Evaluation ◽

Ablation Catheter ◽

Test Bed ◽

3 Dimensional ◽

Catheter Design

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Emerging Nutrition Gaps in a World of Affluence - Micronutrient Intake and Status Globally

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000068 ◽

2011 ◽

Vol 81 (4) ◽

pp. 238-239 ◽

Cited By ~ 3

Author(s):

Manfred Eggersdorfer ◽

Paul Walter

Keyword(s):

Developing Countries ◽

Human Health ◽

Old Age ◽

Molecular Basis ◽

Health Benefit ◽

Developed Countries ◽

Micronutrient Deficiencies ◽

New Science ◽

Health And Nutrition ◽

Micronutrient Intake

Nutrition is important for human health in all stages of life - from conception to old age. Today we know much more about the molecular basis of nutrition. Most importantly, we have learnt that micronutrients, among other factors, interact with genes, and new science is increasingly providing more tools to clarify this interrelation between health and nutrition. Sufficient intake of vitamins is essential to achieve maximum health benefit. It is well established that in developing countries, millions of people still suffer from micronutrient deficiencies. However, it is far less recognized that we face micronutrient insufficiencies also in developed countries.

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Vitamin D Deficiency in Patients with Acute Myocardial Infarction: An Italian Single-Center Study

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000220 ◽

2015 ◽

Vol 85 (1-2) ◽

pp. 23-30 ◽

Cited By ~ 19

Author(s):

Aneta Aleksova ◽

Rita Belfiore ◽

Cosimo Carriere ◽

Salam Kassem ◽

Salvatore La Carrubba ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Primary Source ◽

Sun Exposure ◽

Female Gender ◽

Developed Countries ◽

Vitamin D Status ◽

High Exposure

Abstract. Background: Hypovitaminosis D is a vitamin deficiency that has been increasing in developed countries; it was also suggested as an emerging risk factor for developing of atherosclerosis and acute myocardial infarction. The primary source of vitamin D is its cutaneous synthesis under exposure to sunlight. It has been suggested that 30 min of sun exposure twice weekly leads to sufficient vitamin D synthesis. The residents of Trieste (Italy) are well-known for their high exposure to sunlight in all seasons. We aimed to investigate the vitamin D status in subjects with acute myocardial infarction living in this area. Methods: Vitamin D status was identified in 478 subjects diagnosed with acute myocardial infarction. Results: The median serum 25-hydroxyvitamin D concentration was 14.5 [7.8 - 22.7] ng/mL. Vitamin D deficiency and insufficiency were present in 324 (68 %) and 107 (22 %) subjects, respectively. Vitamin D deficiency was less frequent among subjects enrolled in the period from July to the end of September (p < 0.001). In a multivariate analysis vitamin D deficiency was predicted by older age (p = 0.02), female gender (p = 0.002), higher body mass index (p = 0.05), autumn/winter sampling (p < 0.001), increased parathyroid hormone (p = 0.03) and alkaline phosphatase (p = 0.003). Conclusions: We observed very high prevalence of vitamin D deficiency among subjects with myocardial infarction in all seasons of enrollment. However, it was lower in the summer when sun exposure is higher. The exposure to sunlight may be a cost-saving therapeutic strategy for the management of vitamin D deficiency.

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Quantification of Vitamin A in Fortified Rapeseed, Groundnut and Soya Oils Using a Simple Portable Device: Comparison to High Performance Liquid Chromatography

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000154 ◽

2013 ◽

Vol 83 (2) ◽

pp. 122-128 ◽

Cited By ~ 4

Author(s):

Cécile Renaud ◽

Jacques Berger ◽

Arnaud Laillou ◽

Sylvie Avallone

Keyword(s):

High Performance Liquid Chromatography ◽

Liquid Chromatography ◽

Vitamin A ◽

High Performance ◽

Vitamin A Deficiency ◽

Developed Countries ◽

Portable Device ◽

Least Developed Countries ◽

Control Food ◽

Assay Precision

Vitamin A deficiency is still one of the major public health problems in least developed countries. Fortification of vegetable oils is a strategy implemented worldwide to prevent this deficiency. For a fortification program to be effective, regular monitoring is necessary to control food quality in the producing units. The reference methods for vitamin A quantification are expensive and time-consuming. A rapid method should be useful for regular assessment of vitamin A in the oil industry. A portable device was compared to high-performance liquid chromatography (HPLC) for three plant oils (rapeseed, groundnut, and soya). The device presented a good linearity from 3 to 30 mg retinol equivalents per kg (mg RE.kg- 1). Its limits of detection and quantification were 3 mg RE.kg- 1 for groundnut and rapeseed oils and 4 mg RE.kg- 1 for soya oil. The intra-assay precision ranged from 1.48 % to 3.98 %, considered satisfactory. Accuracy estimated by the root mean squares error ranged from 3.99 to 5.49 and revealed a lower precision than HPLC (0.4 to 2.25). Although it offers less precision than HPLC, the device estimates quickly the vitamin A content of the tested oils from 3 or 4 to 15 mg RE.kg- 1.

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Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽

10.1024/0301-1526/a000771 ◽

2019 ◽

Vol 48 (3) ◽

pp. 262-269 ◽

Cited By ~ 3

Author(s):

Christian-Alexander Behrendt ◽

Tilo Kölbel ◽

Thea Schwaneberg ◽

Holger Diener ◽

Ralf Hohnhold ◽

...

Keyword(s):

Multidisciplinary Team ◽

Positive Impact ◽

Cross Sectional Study ◽

Invasive Treatment ◽

Cross Sectional ◽

Hospital Outcomes ◽

Vascular Intervention ◽

Medical Specialties ◽

Team Decision ◽

The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

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