DEVELOPMENT OF A PATIENT-SPECIFIC SIMULATOR BASED ON A REAL-TIME ELECTROMAGNETIC CATHETER TRACKING FOR LEFT ATRIAL APPENDAGE OCCLUSION PROCEDURE

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias and it is associated with an increased risk of thromboembolic events, mainly due to thrombus formation within the left atrial appendage (LAA). For AF patients with contraindications to oral anticoagulants, LAA occlusion (LAAO) is indicated as an effective prevention strategy. However, the LAAO procedure is challenging due to the high anatomical variability of the LAA, thus highlighting the importance of advanced training tools for precise device placement. This thesis focuses on the development of a simulator using an electromagnetic (EM) tracking system to improve LAAO procedural training. The system integrates sensorized catheters for real-time navigation within 3D printed models, allowing clinicians to practice in a realistic and controlled environment. The experimental setup includes a customized anatomical simulator, an EM tracking system (Aurora, Northern Digital Inc.), and the open-source navigation software CustusX (SINTEF Digital). Two patient-specific deformable models were 3D printed using thermoplastic polyurethane to replicate different LAA morphologies. The system was tested in the cath-lab by expert clinicians to perform the deployment of the device into the two different models while tracking catheters’ positions in real-time. The results indicate that the simulator effectively replicates both anatomical and procedural conditions, demonstrating its value for the improvement of procedural skills while reducing patient risk. These findings suggest that integrating tracking technologies into a clinical setting may improve LAAO procedural outcomes, thus opening up additional avenues for pre-procedural training.