EP Lab Digest - May 2008 - (Page 48)

48 ON THE HORIZON MAY 2008 On the Horizon: A New Remote Catheter Manipulation System Interview by Jodie Elrod I n this interview, Gregory M. Ayers, MD, PhD, Medical Advisor of Catheter Robotics, Inc. (CRI), discusses their new catheter manipulation system. Figure 2. Dr. Ayers testing the CRI robot’s catheter manipulation capabilities and comparing it side-by-side to manual electrophysiology catheter manipulation in the animal study. Tell us about the Catheter Robotics Manipulation System by CRI. What are the key features? the fluoroscope. This is important since EP studies can be lengthy, occasionally exceeding 4-6 hours, with significant fluoroscopy The Catheter Robotics Manipulation times.With remote manipulation using this System (Figure 1) design was based on the system, the operator can have full control of catheter navigation without being in the xfollowing principles: • The system allows remote manipulation ray field. The system is comprised of a remote of conventional, commercially-available catheter manipulator (robot) with a remote EP catheters; • The remote control fully replicates the control handle, which enables the user to control the robot that manipulates a standard functions of the catheter handle; • No part of the robotic system enters the EP catheter into 3 degrees: insertion and withdrawal; deflection; and rotation. The patient’s body; • The EP catheter enters the vasculature remote device replicates manual manipulathrough a standard, commercially- tion of the catheter handle and its various controls, allowing the physician using the available sheath-introducer in the groin; • At any point in a procedure, the catheter remote control handle to remain out of the can be removed from the robotic system, fluoroscopy field while still being able to manipulated manually and then placed accomplish the standard catheter maneuvers back into the system for further remote necessary to perform an EP study. In addition, at any point during the EP procedure, manipulation; and, • All force is applied to the catheter the operator can remove the catheter from through the handle, just as if it were held the robot and manipulate it manually. The catheter can then be re-attached to the by the operator’s hand. robot, and remote manipulation is resumed, The system is based on a remote control all without breaking sterility. The system also does not require a special handle that allows manipulation and positioning of the tip of a catheter at the target sheath introducer or sheath system; it is location, thus eliminating the necessity for designed to manipulate catheters inserted the operator to remain in close proximity to through any standard introducer sheath.The system is designed to also manipulate any commercially available EP catheter; therefore, no special catheters are required. In addition, with the CRI system the catheter functions as if it was being manipulated by hand; therefore, if too much force is applied, it will buckle, just the same Figure 1. The Catheter Robotics Manipulation as it would during manual manipuSystem. A standard catheter can be rapidly lation. In addition, the system does placed into the robot and connected to a standard introducer sheath. The system can not change the normal catheter be controlled using a small control station, forces within the heart because the which is very similar to the handle of a mapforce is applied to the catheter from ping catheter (see insert). This catheter can be disengaged from the robot and manually outside of the body, the same as manipulated at any time, and then placed with manual manipulation. back in the robot for additional remote Finally, robotic systems to date manipulation. This product is limited by federal law to investigational use only. have been characterized by a high Figure 3. Dr. Greg Ayers at the Boston Atrial Fibrillation Symposium, at the Catheter Robotics Inc. booth, holding the catheter robotics control station (a small intuitive device similar to the handle of an EP catheter) with their robotic system in the background. Dr. Ayers is standing next to the company's CEO, Mr. David Jenkins. price tag coupled with the use of expensive and frequently limited disposable sheaths and catheters.This CRI system may be able to provide a less costly alternative while at the same time not limit a physician’s choice of sheaths and catheters. Can you tell us about the initial use of this system? In a series of animal studies we conducted, we were able to position the remotely manipulated catheter in close approximation to the catheter tip of the manually manipulated catheter, usually within 3-7 mm. Adequate tissue contact was achieved based on pacing thresholds obtained from both catheters. Additionally, equivalent His bundle recordings were obtained with robotic

Table of Contents Feed for the Digital Edition of EP Lab Digest - May 2008

EP Lab Digest - May 2008 Is There an Under-Referral of Women for Atrial Fibrillation Ablation? A Hybrid Approach to the Cure of Atrial Fibrillation Contents Letter from the Editor Spotlight Interview: University of Michigan Health System 10-Minute Interview: Amit J. Shanker, MD Modular EP Units: Are They Possible? One Hospital’s Experience All About My Job: Technician Supervisor (New Column!) Alcohol Septal Ablation in the Cath Lab: What is it All About? About the Canadian Heart Rhythm Society: Interview with Martin J. Gardner, MD, FRCP(C), FACC Email Discussion Group: May 2008 Second Annual Salary Survey My First Year in Electrophysiology: What Have I Got Myself Into? Highlight on Technology: Video-Audio Integration for the EP Lab On the Horizon: A New Remote Catheter Manipulation System Striving for Excellence in the Care of Cardiac Patients Five Reasons to Participate with a Professional Organization Suspected Shunting of Defibrillation Energy in the EP Lab Can Digital Music Players Cause Interference with Implantable Devices? ECG 101: Ambulatory ECG Monitoring Events Calendar Industry News and Products Classifieds Advertisers Index

EP Lab Digest - May 2008

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