Anthropomorphic simulator for minimally invasive epicardial access procedures

Abstract

We have developed a prototype, in vitro anthropomorphic model for simulating pressure-guided, subxiphoid access procedures done to enable minimally invasive epicardial cardiac procedures including treatments for ventricular tachycardia. Life-size replicas of the heart and lungs were modelled using anatomically accurate surrogates. The dynamic pressure–frequency profiles of simulated pericardial fluid surrounding the water-pumped replica heart were measured and validated against previously acquired human intrapericardial pressure observations (Pearson's r = 0.88, p < 0.001). In replicating access procedures for approaching and entering the pericardial space, the system produced physiologically appropriate pressure measurements at each intermediate point along the needle's insertion pathway. Details of construction and performance are presented and discussed.

Keywords:

• Epicardial ablation
• Epicardial access
• Pericardium
• Thoracic pressure
• Physiological measurements

Acknowledgements

The authors thank Dr F. K. Dorfman (Hospital Monte Klinikum, Fortaleza, Brazil) for providing clinical pericardial pressure–frequency data for the comparison studies. They also thank their colleagues Dr G. Ailawadi (University of Virginia) and Dr M. Scanavacca (University of São Paulo) for several useful discussions, and also University of Virginia biomedical engineering student Anh T. Bui for assistance with the details of construction. The authors have helped initiate the commercial development of this work and will be participating financially in it. This work was supported in part by the Royalty Distribution Program of the University of Virginia Patent Foundation, the University of Virginia's Department of Biomedical Engineering and Johnson & Johnson COSAT Partnership, and the Kopf Family Foundation, Inc.