Evaluation of a Three-Dimensional Printed Interventional Simulator for Cardiac Ablation Therapy Training

• Published in: Applied sciences 2024-09, Vol.14 (18), p.8423
• Main Authors: Saija, Carlo, Sabu, Sachin, Leung, Lisa, Lowe, Ellie, Al-Bahrani, Noor, Coutinho Pinto, Marco Antonio, Herridge, Mark, Chowdhury, Nadia M, Gibson, Gregory, Byrne, Calum, Gabbeta, Adharvan, Marion, Ewen, Chavan, Rashi, Behar, Jonathan, Pontiki, Antonia Agapi, Berthet-Rayne, Pierre, Housden, Richard James, Rhode, Kawal
• Format: Article
• Language: English
• Subjects: 3-D printers; 3D printing; Ablation; Ablation (Surgery); cardiac ablation; Cardiac arrhythmia; cardiac phantom; Catheters; fluoroscopy guidance; Heart; Heart beat; interventional training; Intubation; medical simulator; Polyvinyl alcohol; Training
• ISSN: 2076-3417; 2076-3417
• DOI: 10.3390/app14188423

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.