Abstract 11194: Reducing Arm Muscle Activation by Using an Ablation Catheter Torque Tool: Electromyographic Analysis and User Perception

Abstract

Background: Cardiac ablation catheters are small in diameter and require significant finger dexterity and grip strength to maintain stability and maneuver safely. We designed a catheter torque tool to reduce the muscle activation required to manipulate cardiac ablation catheters and improve user perception of task workload. Objective: The purpose of this study was to evaluate muscle usage and user perception when completing a simulated ablation task with and without the use of a novel ablation catheter torque tool. Methods: Participants, comprised of cardiology attendings and fellows, were fitted with surface electromyographic (EMG) sensors on 6 key muscle groups in the left hand and forearm. Maximum voluntary contraction (MVC) was collected for equal comparison among participants. 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-minute simulated radiofrequency lesion. EMG activity normalized to percentage of MVC was collected throughout the task. The task was repeated 4 times, twice with and twice without the torque tool, in randomized order. A NASA Task Load Index (TLX) survey was completed by the participant at the conclusion each task. Results: Thirteen participants completed the study. Using Wilcoxon’s test, there was a significant difference (P < 0.01) in mean percent of MVC in 4 of the 6 muscle groups when comparing bare catheter versus catheter with torque tool: abductor pollicis, brachioradialis, flexor carpi ulnaris, and extensor carpi radialis. The total expended energy for the abductor pollicis (P < 0.01) and extensor carpi radialis (P = 0.02) were significantly reduced. Perceived physical demand, effort, and frustration were also significantly reduced when using the torque tool (P < 0.01). Conclusions: Use of our novel catheter torque tool reduced the amount of muscle activation necessary to manipulate an ablation catheter during a simulated ablation task. Users’ perceived physical demand, effort, and frustration were less when the tool was used. This tool may improve catheter stability, increase procedure safety, and reduce operator stress and muscle fatigue when performing catheter ablation procedures.