Phantom study of augmented reality framework to assist epicardial punctures

Area of Science:

• Medical Technology
• Cardiac Electrophysiology
• Surgical Navigation

Background:

• Percutaneous epicardial access is crucial for cardiac arrhythmia mapping and ablation.
• Improving guidance and accuracy during this procedure can minimize risks and enhance patient outcomes.

Purpose of the Study:

• To evaluate the accuracy of an augmented reality (AR) system for guiding the subxiphoidal approach in epicardial ablation.
• To assess the AR system's ability to improve visualization and needle navigation.

Main Methods:

• Developed an AR application projecting real-time needle trajectories and 3D patient organs using Hololens 2.
• Implemented real-time needle tracking for operator feedback.
• Conducted experiments to evaluate overlay accuracy, puncture accuracy, and pre-clinical phantom evaluations.

Main Results:

• Overlay accuracy with the AR system was $2.36\pm 2.04\mathrm{mm}$.
• Puncture accuracy using AR guidance was $1.02\pm 2.41\mathrm{mm}$.
• Pre-clinical phantom evaluation showed AR-guided needle puncture accuracy of $7.43\pm 2.73\mathrm{mm}$, compared to $22.62\pm 9.37\mathrm{mm}$ without AR.

Conclusions:

• The AR platform demonstrates potential to enhance accuracy in percutaneous epicardial access.
• AR guidance may reduce complications and improve patient outcomes for cardiac arrhythmia ablation.
• This technology offers improved accuracy and safety for percutaneous epicardial access procedures.