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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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  • Paige Mass,
  • Rohan N. Kumthekar,
  • Bradley Clark,
  • Justin D. Opfermann,
  • Elizabeth Sherwin,
  • Luigi DiBiase,
  • Charles I. Berul
Paige Mass
Shiekh Zayed Institute Children’s National Hospital Washington DC

Corresponding Author:[email protected]

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Rohan N. Kumthekar
Nationwide Children's Hospital
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Bradley Clark
Children's Hospital at Montefiore
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Justin D. Opfermann
Johns Hopkins University
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Elizabeth Sherwin
Department of Cardiology Children’s National Hospital Washington DC
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Luigi DiBiase
Montefiore Medical Center
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Charles I. Berul
Shiekh Zayed Institute Children’s National Hospital Washington DC
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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
Dec 2022Published in Journal of Interventional Cardiac Electrophysiology volume 65 issue 3 on pages 757-764. 10.1007/s10840-022-01348-0