Atrial fibrillation (AFib), the most common form of heart arrhythmia, or irregular heartbeat, is a problem with the rate or rhythm of the heartbeat - including beating too quickly or too slow. Many cases of AFib are controlled with medication, but those who cannot tolerate or do not respond to drugs often undergo an ablation procedure known as a Left Atrial Appendage Occlusion (LAAO) for managing stroke risk. In the LAAO procedure, doctors insert a catheter, or flexible tube, through a vein or artery in the groin and thread it up to the heart to deliver an implant that reduces blood clots in the heart that leads to strokes in Afib patients. However, using current technology, the doctor views the heart tissue and manually positions the implant with the help of an X-ray of the heart, which provides only a very hazy picture of the organ.

Now, a team of scientists has received a four-year, USD 3.7 million National Institutes of Health grant to attempt what they say would be a medical first: performing robotic heart catheterization while the patient is inside a magnetic resonance imaging (MRI) machine. A physician controlling a micro-robotic device would perform the procedure wearing a mixed-reality headset and the goal would be to achieve unparalleled surgical precision. By demonstrating the benefits of using AR-guided robotic surgery for the LAAO procedure, the scientists at Case Western Reserve University (Cleveland, OH, USA) hope to increase its availability to AFib patients - especially those whose life expectancy is greater than 20 years. Both of the two big pieces of the work - the robotic catheter operating inside an MRI, and the high-speed MRI imaging itself - provide significant challenges, bringing together several experts from different disciplines.

“Using our technology, the physician would see clinical-quality, soft-tissue images in real time,” said lead researcher M. Cenk Cavusoglu, professor of electrical, computer, and systems engineering and director of the Medical Robotics and Computer Integrated Surgery (MeRCIS) Lab at the Case School of Engineering. “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).” 

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