Abstract 10908: Peri: A Training Phantom for Pediatric Cardiac Ablation

• Published in: Circulation (New York, N.Y.) Vol. 140; no. Suppl_1 Suppl 1; p. A10908
• Main Authors: Mass, Paige N, Opfermann, Justin, Kumthekar, Rohan N, Berul, Charles I
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 19.11.2019
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.140.suppl_1.10908

IntroductionEndocardial ablations require venous access followed by fluoroscopic and/or 3D electroanatomic mapping of the heart. Manipulating the catheter demands significant dexterity and practice which can be difficult for a training physician. Peri is a simulator to practice manipulating an ablation catheter within the infant heart space.HypothesisAn inexpensive and portable trainer for pediatric catheter ablation could be created.MethodsA CT scan was segmented using Mimics software (Materialise) and 3D printed in plastic. Seven targets were placed in the heartSVC, IVC, fossa ovalis, coronary sinus, AV node, slow pathway of the AV node and a right posteroseptal accessory pathway. The SVC, IVC, fossa ovalis, coronary sinus and both pathways were wired to a green light bulb, and the AV node was connected to a red lightbulb and buzzer to alert the user when catheter contact is achieved. The heart was placed inside a hollow body doll with tubing connected from the IVC and SVC to the right femoral and left subclavian regions. A camera provided visualization of the heart. Pediatric residents, cardiology fellows, and cardiac attendings were challenged to locate and contact all 6 positive targets using an ablation catheter without touching the AV node.ResultsEight subjects completed the testing. One attending, 1 fellow, and 1 resident mapped all 6 targets in 2m 55s, 2m 27s and 6m 36s respectively. Five participants were unable to touch all 6 targets, stating they lacked the finger strength to torque the catheter. All unsuccessful subjects agreed they would be able to complete the task with additional practice, and that Peri is a beneficial tool for inexperienced trainees.ConclusionsWe created a simple, inexpensive, portable cardiac ablation trainer. The system accommodates various size pediatric heart models with or without congenital defects, and can be used with varying targets, or can incorporate other training modules such as percutaneous pericardial access.