Image-based guidance for minimally invasive surgical atrial fibrillation ablation.

PURPOSE

Atrial fibrillation (AF) is the most common arrhythmia and results in an increased risk of ischaemic stroke. Recently, a European consortium has developed a new ablation device for minimally invasive surgical AF treatment. The device is controlled by a medical robot. Due to the minimal invasive usage, surgery using the new device needs appropriate navigation support. In this paper, we describe an image-based navigation application to guide the new device intraoperatively.

METHODS

The navigation procedure is based on intraoperative ultrasound. Variations in the position of the ablation device are transferred from the software controlling the robot to the navigation system. Due to the flexibility of the ablation device, a deformation model predicts the behaviour during repositioning. Ablation lines are interactively planned. Actually burned ablation lines are visualized during surgery. Several in vitro and ex vivo experimental set-ups were built up to test the feasibility.

RESULTS

The navigation workflow was implemented into navigation software using well-known open-source software toolkits. The navigation system has been integrated and tested successfully within the overall system. The ablation device could be localized on in vitro and ex vivo ultrasound images.

CONCLUSION

The performed trials proved the applicability of the navigation procedure. More in vivo tests are currently being performed to make the new device and the described navigation procedure ready for clinical use.