Daniel Gelman, PhD Candidate, is using robotics to solve real world clinical problems. With a background in electrical and computer engineering, the trainee is developing devices with the potential to improve cardiovascular interventions. Gelman is completing his doctoral work in Biomedical Engineering and is supervised by Robarts scientist Maria Drangova, PhD.
In this Q&A, he discusses his current research project, which focuses on cardiac ablation therapy.
What does your research focus on?
I’m looking at robotics and cardiovascular image-guided intervention. This involves taking instruments that are used clinically and attaching them to a robot in order to manipulate those instruments more effectively and hopefully improve procedures.
The clinical procedure I’m looking at specifically is cardiac ablation. The odds are you know someone with atrial fibrillation or arrhythmia, which is treated by delivering lesions to the tissue using an ablation catheter. In other words, certain tissue in the heart is burned in order to restore functionality.
This procedure is currently done manually, and the biggest problem is that for 50 per cent of patients, the arrhythmia returns within three months. This means many patients will have to have multiple procedures to eliminate the arrhythmia.
Ideally, we want to increase the first-procedure efficacy rate of this procedure by improving the delivery, accuracy and precision of the lesions.
How are you addressing this clinical problem with your research?
My primary research looks at the amount of contact force the catheter is pushing into tissue during the ablation. Generally, the larger the force, the larger the lesion that is delivered. But you can’t just push hard, because that could ablate collateral tissue or even puncture the heart, while poor contact force will generate a small lesion contributing to the problem of repeat procedures. Ideally, these lesions are delivered with a specified contact force.
My idea was to take this information and implement robotics in order to better control the force. And more importantly, compensate for motion. During procedures, motion occurs regularly – the patient breathes and the heart beats.
I developed a hand-held device which clamps on to commercial ablation catheters that synchronize the catheter with heart motion while maintaining a desired amount of force. So ideally, rather than the clinician controlling the force, they turn on the device and the catheter will deliver the lesion for them.
I built a custom heart phantom to represent what is observed clinically and tested the device. When I turn it on, the robot responds to regulate and control the catheter, and reacts to forces on the tip of the catheter. There’s some sophisticated software that I wrote that synchronizes the catheter with the motion of the heart and learns over time to give a better response.
I’ve also been working on a second robot that works to control the positioning of the catheter. Combined with the smaller device, it positions the catheter robotically and then controls force to deliver the lesion more accurately and precisely.
What are the clinical opportunities with this research?
This force control technology is very unique, and is patent pending. I’m pursuing commercial opportunities with industry partners, and my goal is to commercialize the hand-held device. Force control is a novel problem to solve, so there are many exciting avenues.
What type of support or recognition have you received for your work?
I first presented my research at the Heart Rhythm Society in San Francisco – the leading conference in cardiac electrophysiology, where I received an overwhelming amount of attention from the academic, clinical and industry arenas. The research poster received top prizes at the Imaging Network Ontario Symposium, London Health Research Day, and the Cardiac Arrhythmia Network of Canada's (CANet) annual meeting. Additionally, at the CANet meeting, I gave a presentation to more than 120 of Canada’s leading interventional electrophysiologists, where I introduced the technology and proposed pre-clinical research as a part of a grant competition. I was award First Prize – $25,000 to undertake pre-clinical studies.
During the past year, I have given dozens of demonstrations of the technology to foundations (e.g. Heart and Stroke Foundation Board of Directors), venture capitalists and multi-national medical imaging companies (GE, Phillips, Toshiba, Siemens). All have been tremendously impressed and have inquired about the commercialization plans.
What is your background with this type of research?
I have formal training in electrical and computer engineering. I completed an undergraduate degree at McMaster University, focusing on biomedical applications. My studies involved designing electrical systems, control systems and robotics. I had that knowledge when I started working at Robarts, but I didn’t know much about mechanical engineering, so that’s been a learning process. I’ve developed a lot of skills with this current project.
I started in a master’s program at Schulich Medicine & Dentistry and basically spent a lot of time in the electrophysiology lab at London Health Sciences Centre. I came across catheter force information at that time, and that really sparked my interest. I wanted to see if I could control it. When I presented the idea to my advisory committee, they recommended I take the project through to a PhD.
What motivates you in pursuing this research?
As a kid, I always loved robots, mechatronics, and seeing things automatically move. Building an entire system myself, applying it to a real world problem and seeing it work as intended is extremely rewarding. I enjoy interacting with new technologies and using already existing information and materials to build something new.
I’m a typical nerd. I love building devices and getting them to work. I try to litter my home with electronics and do side projects at home.
What does your regular routine look like?
I do live in the lab. There’s 3D printing involved in this project, designing and soldering circuit boards, troubleshooting and getting things to work properly. I feel like it’s the life of a typical electrical engineer. Now we’re getting into testing and commercial opportunities. It took about three years to get us to this point, to build the devices, design and integrate clinical software.
I regularly give demos of these devices and it is very rewarding to see to how people react to the project and the results.