Researchers from Case Western Reserve University are working toward integrating elements to conduct the first-ever procedure to control stroke risk for patients with atrial fibrillation (AFib).
Cenk Cavusoglu. Image Credit: Case Western Reserve University
The researchers have been awarded a four-year, $3.7 million National Institutes of Health grant to try what they recognize as a medical first: conducting robotic heart catheterization while the patient is positioned inside a magnetic resonance imaging (MRI) machine.
A physician regulating a micro-robotic device would conduct the procedure wearing a mixed-reality headset and the objective would be to accomplish unmatched surgical accuracy.
In this situation, that would mean a procedure called Left Atrial Appendage Occlusion (LAAO), which is used for dealing with stroke risk in patients with AFib.
According to the Centers for Disease Control, around 3-6 million Americans suffer from AFib, the most prevalent kind of heart arrhythmia. Heart arrhythmia, or irregular heartbeat, is an issue with the rate or rhythm of one’s heartbeat—including beating too rapidly or sluggishly, according to the NIH.
During the LAAO procedure, doctors insert a catheter, or malleable tube, through an artery or vein in the groin and direct it up to the heart to convey an implant that decreases blood clots in the heart which causes strokes in patients with Afib.
However, using existing technology, the doctor observes the heart tissue and manually places the implant with the help of an X-Ray of the heart, which offers a very foggy picture of the organ.
Using our technology, the physician would see clinical-quality, soft-tissue images in real-time. He or she would be able to pinpoint the exact location, and the micro-robot would perform the procedure. This would make this procedure safer, easier, far more effective, and even less expensive as a treatment for atrial fibrillation (AFib).
M. Cenk Cavusoglu, Study Lead and Professor, Electrical, Computer, and Systems Engineering, School of Engineering, Case Western Reserve University
M. Cenk Cavusoglu is also the director of the Medical Robotics and Computer-Integrated Surgery (MeRCIS) Lab.
Team Helping Afib Patients
By showing the advantages of using AR-directed robotic surgery for this procedure, the scientists hope to expand its availability to patients with AFib—particularly those whose life expectancy is above 20 years.
Cavusoglu stated that the two big study procedures—the robotic catheter working inside an MRI and the high-speed MRI imaging—offer major challenges. Merging them would necessitate a team of experts from various disciplines.
Cavusoglu is collaborating with Mark Griswold, Professor of Radiology from the Case Western Reserve School of Medicine, and former bioengineering colleague Nicole Seiberlich, currently with the University of Michigan.
Other collaborators include Hiram Bezerra from the University of South Florida, Joseph Piktel from MetroHealth, and Mauricio Arruda from University Hospitals Cleveland Medical Center.
Builds on Previous Work
In 2020, Cavusoglu and his team were given a previous NIH grant to design a system for conducting MRI-guided robotic atrial fibrillation ablation established on the same technology.
Several cases of AFib are managed with medication, but those who cannot endure or do not respond to drugs mostly go through the ablation procedure.
He and his team have been working on the innovative method since 2013 and hope to confirm the technology in pre-clinical studies in the near future, before advancing to human trials.