Automated catheter tip repositioning for intra-cardiac echocardiography

Purpose Intra-Cardiac Echocardiography (ICE) is a powerful imaging modality for guiding cardiac electrophysiology and structural heart interventions. ICE provides real-time observation of anatomy and devices, while enabling direct monitoring of potential complications. In single operator settings, the physician needs to switch back-and-forth between the ICE catheter and therapy device, making continuous ICE support impossible. Two operator setups are sometimes implemented, but increase procedural costs and room occupation. Methods ICE catheter robotic control system is developed with automated catheter tip repositioning (i.e., view recovery) method, which can reproduce important views previously navigated to and saved by the user. The performance of the proposed method is demonstrated and evaluated in a combination of heart phantom and animal experiments. Results Automated ICE view recovery achieved catheter tip position accuracy of 2.09 +/- 0.90 mm and catheter image orientation accuracy of 3.93 +/- 2.07 degrees in animal studies, and 0.67 +/- 0.79 mm and 0.37 +/- 0.19 degrees in heart phantom studies, respectively. Our proposed method is also successfully used during transseptal puncture in animals without complications, showing the possibility for fluoro-less transseptal puncture with ICE catheter robot. Conclusion Robotic ICE imaging has the potential to provide precise and reproducible anatomical views, which can reduce overall execution time, labor burden of procedures, and X-ray usage for a range of cardiac procedures.