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用于房颤治疗的可操控且兼容磁共振成像的心脏导管的研发进展

Towards the Development of A Steerable and MRI-Compatible Cardiac Catheter for Atrial Fibrillation Treatment.

作者信息

Sheng Jun, Wang Xuefeng, Dickfeld Timm-Michael L, Desai Jaydev P

机构信息

Jun Sheng, Xuefeng Wang, and Jaydev P. Desai are with Medical Robotics and Automation (RoboMed) Laboratory in the Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA

T. L. Dickfeld is with University of Maryland Medical Center, Baltimore, MD 21201, USA tdickfel@ som. umaryland. Edu.

出版信息

IEEE Robot Autom Lett. 2018 Oct;3(4):4038-4045. doi: 10.1109/LRA.2018.2861011. Epub 2018 Jul 31.

Abstract

To treat atrial fibrillation (AFib), radiofrequency ablation is usually implemented with a cardiac catheter to block abnormal electrical signals from pulmonary veins. However, it is challenging to manipulate a passive catheter. In addition, the radiation exposure to patients under fluoroscopic guidance has been a concern. To address these two major issues, this work presents the development of a steerable and MRI-compatible cardiac catheter by using shape memory alloy (SMA) as an alternative interventional tool for AFib. The developed cardiac catheter is comprised of a passive and flexible tubing and a steerable tip. The tip is composed of multiple bending modules and each module is actuated by a pair of antagonistic SMA wires. To improve the MRI-compatibility of SMA actuators, the electric current required for SMA actuation is significantly reduced by developing a technique of conductive heating actuation. In this paper, the design and fabrication of the cardiac catheter are presented, followed by modeling the SMA bending module. The working performance of the SMA bending module is experimentally studied. In the end, a proof-of-concept demonstration of the cardiac catheter is performed in an explanted heart.

摘要

为了治疗心房颤动(AFib),通常使用心脏导管进行射频消融,以阻断来自肺静脉的异常电信号。然而,操作被动导管具有挑战性。此外,在荧光镜引导下患者受到的辐射暴露一直是一个问题。为了解决这两个主要问题,这项工作提出了一种可操纵且与磁共振成像(MRI)兼容的心脏导管的研发,该导管使用形状记忆合金(SMA)作为治疗AFib的替代介入工具。所研发的心脏导管由一根被动且灵活的管道和一个可操纵的尖端组成。尖端由多个弯曲模块组成,每个模块由一对拮抗的SMA丝驱动。为了提高SMA致动器的MRI兼容性,通过开发一种传导加热致动技术,显著降低了SMA致动所需的电流。本文介绍了心脏导管的设计与制造,随后对SMA弯曲模块进行了建模。对SMA弯曲模块的工作性能进行了实验研究。最后,在一个离体心脏上进行了心脏导管的概念验证演示。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0dc6/6433117/173071e5dc75/nihms-1503868-f0001.jpg

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