Multi-source motion decoupling ablation catheter guidance for electrophysiology procedures

Abstract

Accurate and stable positioning of the ablation catheter tip during the delivery of radiofrequency impulses in cardiac electrophysiology remains a challenge due to the endocardium motion from multiple sources (cardiac cycle and respiration) and inevitable slippage of the catheter tip. This paper presents a novel ablation catheter guidance framework during electrophysiology procedures. Catheter tip electrode position readings from intraoperative electroanatomical data are used to decouple tip motion from different motion sources as part of the pre-ablation mapping. The resulting information is then used to determine if there is relative slippage between the catheter tip and endocardial surface and is shown as a probabilitymap for online decision support of the ablation process. The proposed decomposition method and the slippage assessment were performed on a retrospective cohort of 19 patients treated for ventricular tachycardia (13 cases) or atrial fibrillation (6 cases) and were also validated on artificially generated signals.