Rapid Fire Abstracts
Juerg Schwitter, MD, PhD
Professor
University Hospital and University of Lausanne, Switzerland
Nora Bacha, BSc
Medical Student (fifth year)
University Hospital Lausanne, CHUV and University of Lausanne, Switzerland, Switzerland
Raphaël Erard, PhD
Engineer
Adis SA, Advanced interactive systems, Lausanne, Switzerland, Switzerland
Giulio Corazza, PhD
Engineer
Adis SA, Advanced interactive systems, Lausanne, Switzerland, Switzerland
Udaranga Wickramasinghe, PhD
Engineer
Adis SA, Advanced interactive systems, Lausanne, Switzerland, Switzerland
Ambra Masi, MD
Cardiologist
University Hospital (CHUV) and University of Lausanne (UNIL), Switzerland
Panagiotis Antiochos, MD
Cardiologist
Cardiac MR Center of the University Hospital Lausanne, CHUV, Switzerland, Switzerland
Cheryl Teres, MD
Cardiologist
Cardiology Division, University Hospital Lausanne, CHUV, Switzerland, Switzerland
Mathieu le Bloa, MD
Cardiologist
Cardiology Division, University Hospital Lausanne, CHUV, Switzerland, Switzerland
Patrizio Pascale, MD
Cardiologist
Cardiology Division, University Hospital Lausanne, CHUV, Switzerland, Switzerland
Sophia Petropoulou, MD
Cardiologist
Cardiac MR Center of the University Hospital Lausanne, CHUV, Switzerland, Switzerland
Samir Bengueddache, MD
Cardiologist
Cardiac MR Center of the University Hospital Lausanne, CHUV, Switzerland, Switzerland
Betim Redzepi, MD
Cardiologist
Cardiac MR Center of the University Hospital Lausanne, CHUV, Switzerland, Switzerland
Hussein Balan, PhD
Engineer
Adis SA, Advanced interactive systems, Lausanne, Switzerland, Switzerland
Georges Caron, PhD
Engineer
Adis SA, Advanced interactive systems, Lausanne, Switzerland, Switzerland
Etienne Pruvot, MD, PhD
Professor
Cardiology Division, University Hospital Lausanne, CHUV, Switzerland, Switzerland
Pascal Fua, PhD
Professor
Computer Science, Federal Institute of Technology Lausanne, EPFL, Lausanne, Switzerland, Switzerland
Arrhythmias are rising worldwide due to population aging. Efficient training of next generation electrophysiologists (EPs) to perform catheter (cath) ablation of arrhythmias is crucial. Dedicated simulators for EP training based on individual patient anatomy do not exist yet.
Purpose
To assess the potential training effects of a novel augmented reality-based simulator for ablations in the interventional MRI.
Methods:
An artificial intelligence and augmented reality-based simulator (ARTSim, Adis SA, Lausanne, Switzerland) utilizes 3D heart models of patients for the planning and simulation of personalized ablation procedures (Figure 1A). This simulator incorporates innovative techniques for digitizing and tracking the movements of a physical ablation cath (Imricor, Burnsville,MN,USA) in real time, thereby enabling its precise navigation within a completely virtual 3D heart (Figure 1B) generated automatically by HeARTS (Adis SA, Lausanne, Switzerland) from patients’ MRI scans. Experienced EPs (n=4) and non-EPs (n=5) were trained on the ARTSim. All doctors performed 5 baseline right atrial flutter ablations (RA-FlAbl) in 5 different hearts, followed by another 15 RA-FlAbl for training. Finally, the RA-FlAbl were performed again in the 5 baseline hearts. First, the doctors had to intubate the CS (with success if cath reaches a predefined target CS location, Figure 1). Then, targets on the ablation line (Figure 1C, yellow point) were approached (with success if cath tip was within 3mm of the target point (white) with force of >3 g (pink) for >5sec (red); =efficacy measures, while force >30g needs to be avoided; =safety measure, Figure 1). Procedure time, cath tip trajectory to the targets, and wall contact with >30g and >50g were recorded for all interventions. The ablation was successful, if all points were ablated within 30 min.
Results:
221 RA-FlAbl procedures were performed successfully (out of a total of 225 interventions) and were used for the analysis. At baseline, the non-EPs had 2.6 times longer procedure time (p< 0.001) and 2.6 times longer cath trajectories (p< 0.001) than the EPs (worse efficacy) and 2.8 times more high force wall contacts (worse safety: for >50 g, p< 0.04, Table, Figure 2). After training on the ARTsim, differences vs EPs were no longer significant for duration, trajectory, and high force contacts (Table, Figure 2). EPs improved slightly for duration and trajectory (Table, Figure 2). The training effect was weaker but still present for CS intubation, per se an easier task than ablation (Table, Figure 2).
Conclusion:
After RA-FlAbl training of non-EPs on the ARTsim simulator, they obtained a comparable efficacy and safety profile as experienced EPs. Experienced EPs also improved in terms of efficacy for RA-FlAbl by training on the ARTsim simulator.
