Int J CARS (2009) 4:307–315 DOI 10.1007/s11548-009-0296-z ORIGINAL ARTICLE Robot-assisted catheter manipulation for intracardiac navigation Yusof Ganji · Farrokh Janabi-Sharifi · Asim N. Cheema Received: 29 October 2008 / Accepted: 24 February 2009 / Published online: 13 March 2009 © CARS 2009 Abstract Objective Manual navigation of intracardiac steerable catheters is inaccurate, requires dexterity for efficient manipulation of the catheter, and exposes the interventional- ist to ionizing radiation. The objective of this research is to develop a system that replaces the interventionalists’s hands in catheter manipulation for accurate and semi-automatic tele-navigation of catheters. Methods Based on a proposed kinematic model for the distal shaft of the catheter, a system has been developed for assisted navigation of intracardiac catheters. When the distal shaft of the catheter lies inside a cardiac chamber, a robotic apparatus is utilized for automatic steering of the catheter tip to reach designated targets within the chamber. Results The catheter modeling was validated through the experiments on three swine. The robotic system could navi- gate the catheter tip to designated targets with a mean distance of 6.53 mm from the target. Conclusion Preliminary in vivo studies demonstrate the fea- sible application of the system in catheter navigation and the validity of catheter modeling and control strategies. Y. Ganji (B ) Department of Electrical and Computer Engineering, University of Waterloo, Waterloo, ON N2L 3G1, Canada e-mail: yganji@ieee.org F. Janabi-Sharifi Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, ON M5B 2K3, Canada A. N. Cheema St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada A. N. Cheema Division of Cardiology, University of Toronto, Toronto, ON M5G 2C4, Canada Keywords Catheter · Intracardiac navigation · Robot-assisted manipulation · Modeling Introduction Steerable electrophysiology (EP) catheters are widely used in the interventional treatment of cardiac arrhythmias. In an EP session, the interventionalist or electrophysiologist manipulates the catheter handle and its steering knob to bring the catheter electrodes or ablation cap, at the distal shaft of the catheter, in contact with the intracardiac anatomy. Catheter manipulations result in translation, twist, and deflec- tion of the distal shaft, repositioning the shaft inside the car- diac chambers. The major goal of the manipulations is to position the shaft such that a stable contact with the endocar- dium is achieved in order to conduct EP study and ablation. However, the flexible catheter shaft is subject to intracardiac blood flow and cardiac contractions, and the transfer of the manipulations at the handle or proximal section to the shaft is generally non-linear. Consequently, successful position- ing of the catheter is often achieved after repeated attempts depending on the experience, skills, and fatigue of the in- terventionalist. As a result, catheter-based procedures could entail prolonged exposure of the interventionalists and the patients to ionizing radiation of fluoroscopy. To assist catheter steering and navigation, two commercial systems have been developed. Niobe ® (Stereotaxis, St. Louis, MO) realizes magnetic navigation [1, 2] using a special mag- netic catheter. In this system, two permanent magnets are placed on the sides of patient table and the catheter is nav- igated inside their magnetic field. To deploy Niobe ® , the catheterization lab must be magnetically compatible with the system. Niobe ® cannot be deployed on patients that have metallic implants as well. Sensei™ (Hansen Medical, 123