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Visual, Tactile and Contact Force Feedback: which one is more important for catheter ablation? Results from an in vitro experimental study.
MedLine Citation:
PMID:  24252284     Owner:  NLM     Status:  Publisher    
INTRODUCTION: During radiofrequency ablation, effective contact is crucial in determining lesions efficacy. In this study we compared operators' ability to assess contact pressure using visual and tactile feedbacks together or alone in an experimental model.
METHODS: In a in-vitro experimental setup replicating manual catheter manipulation, and recording the applied force, evaluators were asked to identify 3 levels of force (first, ablation and maximum contact) as the catheter contacted the tissue model, using: 1) visual feedback only by fluoroscopy, "blinded" to touch; 2) tactile feedback only, blinded to fluoroscopy; and 3) both tactile and visual feedback together. The latter was regarded as reference. The experiment was repeated using a catheter-force-sensing technology, during robotic navigation.
RESULTS: During manual navigation, tighter association was shown for the Visual than for the Tactile method (median difference with reference: first contact -1 (p=0.97) vs. -2 (p=0.90); ablation contact: 2 (p=0.1) vs. -7 (p=0.03); maximum contact 2, (p=0.06) vs. -28 (p=0.02). Bland-Altman plot and Deming regression confirmed, for the Visual method, the good agreement with reference and the absence of bias at any level, while showing for the Tactile higher values and proportional bias, reaching statistical significance at ablation and maximum contact. During robotic navigation, agreement was higher for the Tactile than for the Visual only method.
CONCLUSIONS: During manual navigation, visual feedback alone is in better agreement with the reference compared to tactile-only approach. During robotic navigation, agreement is looser for the visual-only approach. More objective feedback of contact pressure during ablation procedures is desirable.
Luigi Di Biase; Alessandro Paoletti Perini; Prasant Mohanty; Alex S Goldenberg; Gino Grifoni; Pasquale Santangeli; Francesco Santoro; Javier E Sanchez; Rodney Horton; G Joseph Gallinghouse; Sergio Conti; Sanghamitra Mohanty; Shane Bailey; Chintan Trivedi; Aditi Garg; Aaron P Grogan; Dan T Wallace; Luigi Padeletti; Vivek Reddy; Pierre Jais; Michelle Haissaguerre; Andrea Natale
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-16
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  -     ISSN:  1556-3871     ISO Abbreviation:  Heart Rhythm     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2013 Published by Heart Rhythm Society on behalf of Heart Rhythm Society.
Texas Cardiac Arrhythmia Institute at St. David's Medical Center, Austin, Texas, USA; Albert Einstein College of Medicine at Montefiore Hospital, New York, USA; Department of Biomedical Engineering, University of Texas, Austin, Texas, USA.
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