Cardiac ablation (CA) is an interventional electrophysiological procedure used to disrupt arrhythmic substrates in the myocardium by inducing localized scarring. Current CA training relies on the master–apprentice model. In different fields of medicine including CA, virtual and physical simulators have proven to enhance, and even outperform, conventional training modalities while providing a risk-free learning environment. Despite the benefits, high costs and operational difficulties limit the widespread use of interventional simulators. Our previous research introduced a low-cost CA simulator using a 3D-printed biatrial cardiac model, successfully recording ten ablation lesions on the phantom myocardium. In this work, we present and evaluate an enhanced version: compared to the previous version, the cardiac phantom’s electrical behavior and ablation settings were optimized to produce consistent lesions, while 3D-printed components improved the haptic and radiographic properties of the simulator. Seven cardiologists compared the experimental simulator’s performance to the leading commercial system from Heartroid in a 24-question survey on a 5-point Likert scale. The four following areas of fidelity were considered: catheter entry, anatomical correctness, radiographic appearance, and mapping and ablation. The experimental simulator significantly outperformed the commercial system (p < 0.01), particularly in radiographic appearance (p < 0.01). The results show the potential for the experimental simulator in routine CA training.
Atrial fibrillation, the most prevalent cardiac arrhythmia, is treated by catheter ablation to isolate electrical triggers. Clinical trials on robotic catheter systems hold promise for improving the safety and efficacy of the procedure. However, expense and proprietary designs hinder accessibility to such systems. This paper details an open-source, modular, three-degree-of-freedom robotic platform for teleoperating commercial ablation catheters through joystick navigation. We also demonstrate a catheter-agnostic handle interface permitting customization with commercial catheters. Collaborating clinicians performed benchtop targeting trials, comparing manual and robotic catheter navigation performance. The robot reduced task duration by 1.59 s across participants and five trials. Validation through mean motion jerk analysis revealed 35.2% smoother robotic navigation for experts (≥10 years experience) compared to the intermediate group. Yet, both groups achieved smoother robot motion relative to the manual approach, with the experts and intermediates exhibiting 42.2% and 13.6% improvements, respectively. These results highlight the potential of this system for enhancing catheter-based procedures. The source code and designs of CardioXplorer have been made publicly available to lower boundaries and drive innovations that enhance procedure efficacy beyond human capabilities.