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Muscle usage and workload assessment of cardiac ablation procedure with the use of a novel catheter torque tool in a pediatric simulator

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Abstract

Background

Cardiac ablation catheters are small in diameter and pose ergonomic challenges that can affect catheter stability. Significant finger dexterity and strength are necessary to maneuver them safely. We evaluated a novel torque tool to reduce muscle activation when manipulating catheters and improve perceived workload of ablation tasks. The objective was to evaluate measurable success, user perception of workload, and muscle usage when completing a simulated ablation task with and without the use of a catheter torque tool.

Methods

Cardiology attendings and fellows were fitted with surface electromyographic (EMG) sensors on 6 key muscle groups in the left hand and forearm. A standard ablation catheter was inserted into a pediatric cardiac ablation simulator and subjects navigated the catheter tip to 6 specific electrophysiologic targets, including a 1-min simulated radiofrequency ablation lesion. Time to complete the task, number of attempts required to complete the lesion, and EMG activity normalized to percentage of maximum voluntary contraction were collected throughout the task. The task was completed 4 times, twice with and twice without the torque tool, in semi-randomized order. A NASA Task Load Index survey was completed by the participant at the conclusion of each task.

Results

Time to complete the task and number of attempts to create a lesion were not altered by the tool. Subjectively, participants reported a significant decrease in physical demand, effort, and frustration, and a significant increase in performance. Muscle activation was decreased in 4 of 6 muscle groups.

Conclusion

The catheter torque tool may improve the perceived workload of cardiac ablation procedures and reduce muscle fatigue caused by manipulating catheters. This may result in improved catheter stability and increased procedural safety.

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Acknowledgements

We would like to acknowledge the Team Trace Foundation, the Van Metre Companies Professorship, and the Children’s National Board of Visitors for financial support of our work.

Funding

This research is supported in part by the Team Trace Foundation, the Van Metre Companies Professorship, and the Children’s National Board of Visitors.

Author information

Authors and Affiliations

  1. Shiekh Zayed Institute, Children’s National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA

    Paige N. Mass & Charles I. Berul

  2. Department of Cardiology, Children’s National Hospital, 111 Michigan Ave NW, Washington, DC, 20010, USA

    Paige N. Mass, Elizabeth D. Sherwin & Charles I. Berul

  3. Division of Cardiology, Nationwide Children’s Hospital, Columbus, OH, USA

    Rohan N. Kumthekar

  4. Division of Cardiology, Children’s Hospital at Montefiore, New York, NY, USA

    Bradley C. Clark

  5. Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD, USA

    Justin D. Opfermann

  6. Division of Cardiology, Montefiore Medical Center, New York, NY, USA

    Luigi DiBiase

Authors
  1. Paige N. Mass
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  4. Justin D. Opfermann
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  7. Charles I. Berul
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Corresponding author

Correspondence to Paige N. Mass.

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Ethics approval

This study was approved by the Institional Review Boards at Children’s National Hospital, Nationwide Children’s Hospital, and Albert Einstein College of Medicine/Montefiore Medical Center. The studies were conducted in accordance with the Declaration of Helsinki.

Consent to participate

All participants voluntarily participated in the study after completing an informed consent document. All individuals depicted in the photographs included in this manuscript have provided informed consent of the publication of these photos.

Conflict of interest

Charles Berul, Bradley Clark, Justin Opfermann, and Paige Mass are co-inventors of the torque tool evaluated in this article.

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Mass, P.N., Kumthekar, R.N., Clark, B.C. et al. Muscle usage and workload assessment of cardiac ablation procedure with the use of a novel catheter torque tool in a pediatric simulator. J Interv Card Electrophysiol 65, 757–764 (2022). https://doi.org/10.1007/s10840-022-01348-0

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  • DOI: https://doi.org/10.1007/s10840-022-01348-0

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