Multi-functional Sensing Catheter for Cardiac Electrophysiology Therapy
Project Title: Multi-functional Sensing Catheter for Cardiac Electrophysiology Therapy
Project Duration: May 23 – July 29, 2016 (10 weeks), 40 hours per week.
Project Mentors –
- Primary Faculty Mentor (Name, Affiliation, website and Email/Phone):
Zion Tsz Ho Tse, PhD, Assistant Prof of Medical Devices, College of Engineering, UGA
Email: firstname.lastname@example.org Tel: 706-542-4189
- Secondary Faculty Mentor (Name, Affiliation, website and Email/Phone):
Dr. Mable Fok, PhD, Assistant Prof of Photonics, College of Engineering, UGA
Email: email@example.com Tel: 706-542-4189
- Graduate Student/PostDoc mentors (Name, Affiliation and Email/Phone):
Kevin J. Wu, Medical Robotics Lab/ Jia Ge, Lightwave and Microwave Photonics Lab, College of Engineering, UGA
Email: firstname.lastname@example.orgemail@example.com Tel: 706-542-4189
Cardiac Electro-physiology (EP) diagnosis and treatment of heart rhythm disorders is a rapidly growing field. More than 2.6 million Americans suffer from Atrial Fibrillation (AF) , and this number is increasing rapidly as the population ages [2, 3]. In addition, 400,000 patients die each year due to Ventricular Tachycardia (VT) . Effective manoeuvring of catheters to access the desired target tissue increases the efficacy of EP therapy.
One complication during EP is perforation of cardiovascular, atrial and ventricular structures, where a catheter is pushed into structural tissue by the electrophysiologist, causing tissue injury, tamponade or piercing through the vessel tissue which can result in severe haemorrhage (Fig. 1a). Perforation is commonly due to poor catheter-tissue force sensing at the catheter tip and poor visualization of cardiovascular structures during EP therapy. Combining force sensing at the catheter tip has been shown to improve the haptic feedback and reduce the chances of tissue damage [5-9].
Force, temperature and curvature sensors based on fiber-optics can be tiny (<0.3mm in diameter) and immune to MRI noise [7, 10, 11], maintaining a large sensing range and spatial resolution . We hypothesize that designing a multi-functional sensor for flexible EP catheters could measure, in real-time, the axial and lateral forces, ablation temperature and curvatures at the catheter tip simultaneously, which are important parameters for monitoring catheter ablation and manipulation. The design is based on a novel application of the Fiber Bragg Grating (FBG), which is inexpensive to fabricate (<$20 per catheter) and is compatible and safe with MRI, CT and ultrasound imaging modalities.
REU Student Role and Responsibility:
Task 1: Constructing Catheter FBG sensors
The multi-functional FBG-array sensor will be fabricated by “writing” multiple FBGs on a piece of optical fiber. Each of the FBGs has different reflection wavelength (Fig. 1b) for different sensing parameters. The FBG-array sensor will be mounted on the catheter in a unique configuration (Fig. 1c), in which the part closest to the tip is wrapped around the catheter in a spiral pattern with a small patch, while the rest of the FBG-array is wrapped on the catheter with a gradually increasing pitch and then straightened out. This wrapping pattern encodes axial force, lateral force, curvature and temperature sensing measurements.
Task 2: Measurement setup
A custom-made fiber-optics system will be used for measurements (Fig. 1d-e). The FBG-array sensor connects to the input of the system (port 2). Laser diode array is used to provide multiple wavelengths to the FBG-array sensor through an optical circulator. While light that is reflected from the FBG-array sensor at port 2 goes to port 3. The reflected light that carries the sensing parameters, is separated according to the wavelength (and sensing function), and is detected by individual photodetectors (PDs) for optical-to-electrical signal conversion. The signal is sent to a computer for analysis of the sensing information. Performance of the FBG multi-function sensor will be evaluate and calibrate to the lateral and axial force at the catheter tip, and the temperature and curvature at the catheter.
Expected Outcome for REU student: The student’s work will contribute to the development of publications, aimed for submission as a conference paper in the International Society for Magnetic Resonance Imaging (ISMRM). Upon completion of the entire project, a comprehensive paper on the device will be submitted for journal publication. The device may also be in consideration for commercialization pending experimental outcomes.
 V. Fuster, L. E. Rydén, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, et al., “ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (writing committee to revise the 2001 guidelines for the management of patients with atrial fibrillation) Developed in Collaboration with the European Heart Rhythm Association and the Heart Rhythm Society,” Journal of the American College of Cardiology, vol. 48, pp. 854-906, 2006.
 P. A. Wolf, E. J. Benhamin, A. J. Belanger, W. B. Kannel, D. Levy, and R. B. D’Agostino, “Secular trends in the prevalence of atrial fibrillation: The Framingham Study,” American heart journal, vol. 131, pp. 790-795, 1996.
 Y. Miyasaka, M. E. Barnes, B. J. Gersh, S. S. Cha, K. R. Bailey, W. P. Abhayaratna, et al., “Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence,” Circulation, vol. 114, pp. 119-125, 2006.
 E. M. Aliot, W. G. Stevenson, J. M. Almendral-Garrote, F. Bogun, C. H. Calkins, E. Delacretaz, et al., “EHRA/HRS Expert Consensus on Catheter Ablation of Ventricular Arrhythmias Developed in a partnership with the European Heart Rhythm Association (EHRA), a Registered Branch of the European Society of Cardiology (ESC), and the Heart Rhythm Society (HRS); in collaboration with the American College of Cardiology (ACC) and the American Heart Association (AHA),” Europace, vol. 11, pp. 771-817, 2009.
 Y. L. Park, S. Elayaperumal, S. Ryu, B. Daniel, R. Black, B. Moslehi, et al., “MRI-compatible Haptics: Strain sensing for real-time estimation of three dimensional needle deflection in MRI environments,” in International Society for Magnetic Resonance in Medicine (ISMRM), 17th Scientific Meeting and Exhibition,(Honolulu, Hawaii), 2009.
 P. Puangmali, K. Althoefer, and L. D. Seneviratne, “Novel design of a 3-axis optical fiber force sensor for applications in magnetic resonance environments,” in Robotics and Automation, 2009. ICRA’09. IEEE International Conference on, 2009, pp. 3682-3687.
 P. Polygerinos, P. Puangmali, T. Schaeffter, R. Razavi, L. D. Seneviratne, and K. Althoefer, “Novel miniature MRI-compatible fiber-optic force sensor for cardiac catheterization procedures,” in Robotics and Automation (ICRA), 2010 IEEE International Conference on, 2010, pp. 2598-2603.
 H. Su, M. Zervas, G. A. Cole, C. Furlong, and G. S. Fischer, “Real-time MRI-guided needle placement robot with integrated fiber optic force sensing,” in Robotics and Automation (ICRA), 2011 IEEE International Conference on, 2011, pp. 1583-1588.
 R. C. Susil, C. J. Yeung, H. R. Halperin, A. C. Lardo, and E. Atalar, “Multifunctional interventional devices for MRI: a combined electrophysiology/MRI catheter,” Magnetic resonance in medicine : official journal of the Society of Magnetic Resonance in Medicine / Society of Magnetic Resonance in Medicine, vol. 47, pp. 594-600, 2002.
 X. Liu, I. I. Iordachita, X. He, R. H. Taylor, and J. U. Kang, “Miniature fiber-optic force sensor based on low-coherence Fabry-Pérot interferometry for vitreoretinal microsurgery,” Biomedical Optics Express, vol. 3, pp. 1062-1076, 2012.
 H. Su and G. S. Fischer, “A 3-axis optical force/torque sensor for prostate needle placement in magnetic resonance imaging environments,” in Technologies for Practical Robot Applications, 2009. TePRA 2009. IEEE International Conference on, 2009, pp. 5-9.
 D. Shah, H. Lambert, A. Langenkamp, Y. Vanenkov, G. Leo, P. Gentil-Baron, et al., “Catheter tip force required for mechanical perforation of porcine cardiac chambers,” Europace, vol. 13, pp. 277-283, 2011.