Force and torque clamp

Abstract

The invention relates to an apparatus for calibrating a conduit, the apparatus consisting of a clamp having a base defining a first axis orthogonal to the base. A frame is coupled to the base and configured to rotate about a second axis orthogonal to the first axis. A conduit support is coupled to the frame and configured to hold the conduit and rotate the conduit about a third axis orthogonal to the second axis. The clip also has a meter coupled to the base and to the distal end assembly of the catheter. The meter is configured to provide an indication of a force on the distal end assembly in response to translation of the distal end assembly along the first axis.

Description

Technical Field

[0001] The present disclosure generally relates to catheterization and, more particularly, to calibrating a catheter. Background Art

[0002] During a cardiac ablation procedure, the contact force between an electrode and the tissue to be ablated is an important parameter for both pulsed field ablation (PFA) and radiofrequency (RF) ablation. The quality and depth of the ablation achieved are related to the force applied. Brief Description of the Drawings

[0003] The present disclosure will be understood from the following detailed description in conjunction with the accompanying drawings, in which:

[0004] Figure 1 is a schematic block diagram of an ablation system according to an example of the present disclosure;

[0005] Figure 2 is a schematic perspective view of an ablation system according to an example of the present disclosure;

[0006] Figure 3A and Figure 3B is a schematic view of a distal end assembly of a catheter used in a calibration system according to an example of the present disclosure; and

[0007] Figure 4 is a schematic view illustrating the relationship between the axes of a calibration system according to an example of the present disclosure. Detailed Description

[0008] Overview

[0009] Pulsed field ablation (PFA) and radiofrequency (RF) ablation are cardiac procedures that use a catheter, which can be used to restore the heart to its sinus rhythm. During the procedure, a physician manipulates the catheter such that the electrodes on the distal end of the catheter contact a selected site within the heart, and when contact is achieved, ablation can be activated.

[0010] To reduce the procedure time and simplify the procedure, it is advantageous to use a catheter having a distal end assembly with multiple electrodes, such as a catheter having a basket or balloon distal end (referred to herein as a basket catheter), such that multiple sites can be contacted simultaneously. Further, to reduce time further, in some examples, at least some of these electrodes can be activated simultaneously.

[0011] The distal end assembly of the basket catheter can be inserted into the heart through a minimally invasive method, such as through the femoral artery. The physician manipulates the proximal end of the catheter shaft to position the assembly at a desired location and engage the electrodes against the tissue with a desired force. When the electrodes are engaged with the tissue, manipulation of the proximal end can apply torque to the distal end assembly. Since the distal end assembly is flexible, this torque can cause the distal end assembly to twist. The present inventors have observed that, in some cases, the distal end assembly may untwist relatively suddenly after the torque is applied, which may result in trauma to the heart tissue and / or interference with the performance of ablation.

[0012] The distal end assembly includes a three-dimensional (3D) position sensor that enables measurement of the orientation of the assembly relative to the catheter shaft to which the assembly is attached.

[0013] Examples of the present disclosure provide a fixture capable of measuring the position of the 3D sensor of the assembly to measure the twist of the assembly. The fixture is capable of applying force and torque to the distal end assembly and, in addition, is capable of measuring the applied force and torque.

[0014] Data obtained from the fixture enables a correspondence to be formed between the orientation of the assembly relative to the catheter shaft and the force and torque applied to the distal end assembly. During the procedure, this correspondence can be used to find the force and torque on the distal end assembly of the basket catheter used in the procedure. Knowledge of the torque value enables a warning to be issued if the torque exceeds a preset limit to prevent sudden untwisting of the distal end assembly of the catheter during the procedure.

[0015] System Description

[0016] In the following description, like elements are identified by the same reference numerals and are distinguished, if necessary, by adding a letter suffix to the numeral.

[0017] Now refer to Figure 1 、 Figure 2 and Figure 3A and Figure 3B ,which are respectively a schematic block diagram of a calibration system 10 according to an example of the present disclosure, a schematic diagram of the system, and a schematic diagram of a catheter distal end assembly 14 used in the calibration system. The distal end assembly 14 is attached to the shaft 16 of the catheter 18, and in Figure 2 and Figure 3A and Figure 3B ,the distal end 14 is shown as a basket having a plurality of generally similar splines 20 on which generally similar electrodes 24 are mounted. (In Figure 1In [the figure], the distal end assembly is schematically shown as a circle. However, other distal end assemblies may be in the form of a balloon, such that the distal end assembly 14 may also be referred to herein as a basket 14 or a balloon 14, and the catheter 18 may also be referred to as a basket catheter 18.

[0018] System 10 includes a clamp 22, and two views of the clamp are shown in Figure 2 [the figure]. These views are drawn on the xyz Cartesian axes, which will be further described below. The clamp 22 holds the distal end assembly 14 and is operable to selectively deflect, twist, and / or press the distal end assembly 14 in a defined manner. During the operation of the calibration system, a 3D strain gauge senses the strain applied due to the selective manipulation of the distal end assembly, and the positioning pad 26 is used to enable the measurement of the position and orientation of sensors 30A, 30B, 30C mounted on the distal segment of the distal end assembly 14 and sensors 30D and 30E mounted on the distal end of the shaft 16. Sensors 30A, 30B, 30C, 30D, and 30E are also referred to herein as sensors 30, and each sensor generates a corresponding signal indicative of the position and orientation of the sensor.

[0019] The sensors 30 are typically single-axis sensors (SAS), but in some examples, at least some of the sensors 30 may include biaxial sensors (DAS) and / or triaxial sensors (TAS). The sensors 30, together with the positioning pad 26, are used for magnetic position sensing, and details of the magnetic position sensing technique using a radiating alternating magnetic field are described in U.S. Pat. Nos. 5,539,199, 5,443,489, 5,558,091, 6,172,499, 6,239,724, 6,332,089, 6,484,118, 6,618,612, 6,690,963, 6,788,967, and 6,892,091.

[0020] The positioning pad 26 includes a plurality of generally similar magnetic coils 28, each generally similar magnetic coil being configured to generate a magnetic field, and in this example, there are three coils 28, two of which are visible in Figure 2 [the figure]. The magnetic field from the coils 28 induces a signal in the sensors 30, and the signals from the sensors are used to determine the position of each of the sensors 30 as described below.

[0021] In some examples, a magnetic coil 44 configured to generate a magnetic field is located on the distal end of the shaft 16, and sensors 30A, 30B, and 30C are configured to sense their position and orientation relative to the coil 44 in response to signals induced in the sensors due to the presence of the generated magnetic field from the coil 44. Additionally, signals can be induced in each of the sensors 30A, 30B, 30C, 30D, and 30E based on a magnetic field generated from the coil 28 on the positioning pad. Each of the coils can be configured to generate a magnetic field at a dedicated AC frequency such that the signals induced on the sensors 30A, 30B, 30C, 30D, and 30E from different generating coils can be distinguished.

[0022] The processor 34 sends data for operating the clamp 22 and drive signals for the positioning pad. The processor receives force-related data from the 3D strain gauges 36 in the clamp, and in the disclosed example, the strain gauges are also configured to provide torque-related data to the processor. In an alternative example, a separate torque gauge 40, further described below, provides torque data to the processor. The relationship between strain and force (and / or torque) can be stored in a memory associated with the processor 34.

[0023] The processor also receives position and orientation data for each of the sensors 30 via the position signals of the respective sensors, and the processor forms a correspondence between the two sets of data, namely the correspondence between the force and torque data and the deflection of the distal end assembly based on the sensed position and orientation data. For the same type of catheter used in a medical procedure, this correspondence can be used to find the forces and torques on the distal end assembly for deflections of different shapes of the distal end assembly of the basket catheter. As described above, the strain gauges 36 provide force-related data to the processor 34.

[0024] The clamp 22 includes three actuators that are controlled by the processor 34 and are used to selectively twist and deflect the distal end assembly. By way of example, in the present disclosure, it is assumed that the actuators include motors, but those of ordinary skill in the art will know other types of actuators, such as linear translators or cables, and all such actuators are assumed to be included within the scope of the present disclosure.

[0025] The first actuator 38 (also referred to herein as motor 38) is mounted on the fixed base 42 of the clamp and drives a cam 46. Illustration 48 illustrates the motor 38 and the cam 46.

[0026] As described below, operation of the motor linearly moves the cam 46 for supporting the platform 50 of the distal end assembly 14. As described above, views of the fixture 22 have been drawn on an orthogonal set of Cartesian xyz axes, and in the present specification, the x-axis and the y-axis are parallel to the edges of the fixed base 42 and are located on the upper side of the fixed base, and the z-axis is orthogonal to the fixed base and passes through the center of the platform 50, which is also in the xy plane. In the specification, the xy plane is also assumed to be a horizontal plane, and the direction of the z-axis is assumed to correspond to the vertical direction.

[0027] The cam 46 cooperates with a pad 58 mounted on the base 54 via a contact 58 embedded in the upper side of the movable base 54, and the movable base operates as a class 1 lever and is also referred to herein as the lever 54. Two supports 62 are embedded in the lower side of the base 54, and these two supports contact the fixed base 42 and act as the fulcrum of the base when the base 54 operates as a lever. Thus, rotation of the cam 46 driven by the motor 38 provides a lever force to the segment 66 of the base 54 about the pad 58, thereby pushing this segment to move approximately linearly in the vertical direction.

[0028] When the segment 66 moves linearly, the segment 70 of the base 54 on the side of the supports 62 opposite to the segment 66 also moves approximately linearly and vertically in a direction opposite to that of the segment 66, because the base 54 acts as a lever. Thus, when a lever force is applied to the segment 66, a corresponding lever load is generated on the segment 70. The segment 70 cooperates with a strain gauge support rod 74, which in turn moves vertically parallel to the z-axis by being constrained to travel in vertical grooves 78, 82 in the respective frame supports 86, 90. The frame supports 86, 90 are fixedly connected to the fixed base 42 at the upper side of the fixed base.

[0029] The strain gauge support rod 74 supports a strain gauge 36, which is connected to the platform 50 on the upper surface of the unit. This connection is configured such that the strain gauge 36 provides a force signal corresponding to the vector force acting on the platform 50. When implemented to measure torque, the strain gauge 36 also provides a torque signal corresponding to the torque about the z-axis acting on the platform.

[0030] The second actuator 94 (also referred to herein as motor 94) is mounted on the frame support 86 of the clamp and, in operation, is configured to rotate the frame 98 about an axis 102 that is parallel to the x-axis and passes through the frame supports 86 and 90. Since the frame supports 86 and 90 are fixed to the base 42, the axis 102 does not move relative to the base. As further explained below, rotation of the frame 98 causes the distal end assembly 14 to rotate about the axis of rotation 102, and this axis is configured to pass generally through the center of the distal end assembly. The motor 94 uses a gear train 106 to rotate the frame 98. As illustrated, a weight 110 is attached to the frame 98, and the weight is selected such that the frame is "balanced" about the axis 102.

[0031] A third actuator 114 (also referred to herein as motor 114) is mounted on the frame 98. A catheter clamping assembly 118 is also mounted on the frame 98, and this catheter clamping assembly serves as a catheter support and is configured to grip the shaft 16 of the catheter 18 and rotate the shaft about an axis 122 that is defined by and coincides with the shaft 16. In the disclosed example, a torque gauge 40 is connected to the assembly 118 and is configured to measure the torque of the shaft 16 about the axis 122 when the shaft 16 is rotated by the actuator 114. The axis 122 is orthogonal to the axis 102. The actuator 114 is coupled to the clamping assembly 118 by a gear train 126 such that operation of the actuator 114 causes the shaft 16 of the catheter 18 to rotate about the shaft (i.e., about the axis 122).

[0032] Now refer to Figure 4 , which is a schematic diagram illustrating the relationship between the z-axis, the axis 102, and the axis 122 according to an example of the present disclosure. In Figure 4 , the distal end assembly 14 is schematically drawn as a circle. In this figure, the z-axis and the axis 122 are in the plane of the paper, and the axis 102 is orthogonal to the plane of the paper. In Figure 4 the disclosed example illustrated, all three axes (the z-axis, the axis 102, and the axis 122) intersect at a common point 130. The clamp 22 is configured such that the common point 30 is generally located at the center of the distal end assembly 14.

[0033] Returning to Figure 1 , Figure 2 and Figure 3A and Figure 3B , it will be understood that when the shaft 16 is gripped by the clamping assembly 118, the clamp can be considered to be in a "zero" position in which the frame 98 is adjusted such that the shaft 16 is aligned with the z-axis. This is illustrated in Figure 3A . Rotation of the frame 98 about the axis 102 from the zero position causes the distal end assembly 14 to rotate about the axis 102 such that the shaft 16 is no longer aligned with the z-axis. A typical rotation is illustrated in Figure 3B .

[0034] Operation of the Calibration System

[0035] In the following description, it is assumed that the torque is measured by strain gauge 36. If a torque meter 40 is used to measure the torque, those of ordinary skill in the art will be able to adjust this specification with the necessary changes. During operation of system 10, the distal end assembly 14 can be translated and / or compressed along the z-axis and can be rotated about axis 102 and axis 122. To hold the distal end assembly 14 in a preset position, where in the disclosed example the center of the distal end assembly is approximately at common point 130, the platform 50 is configured to have a plurality of posts 134 protruding from the platform. In the illustrated example, there are three posts 134 near the center of platform 50, but other examples may have other numbers for the plurality and / or other positions of the posts.

[0036] When the distal end assembly 14 is formed as a basket with splines 20, the posts 134 can be configured to interlock with the splines, as illustrated in FIG. 3. This interlock prevents the distal end assembly 14 from moving laterally while still allowing the distal end assembly to rotate, twist, and / or compress through the action of actuators 38, 94, and 114. When the distal end assembly 14 is formed as a balloon, the posts 134 can be moved further from the center of platform 50 to grip the balloon while still allowing the balloon to rotate, twist, and / or compress under the action of the actuators.

[0037] As Figure 1 schematically shown, during operation of system 10, the processor 34 provides fixture settings to the fixture 22, including settings for actuators 38, 94, and 114. The processor 34 also provides drive signals to coils 28 and 44 of the positioning pad 26. The processor 34 receives position and orientation signals from the sensors 30 generated in response to the magnetic radiation they receive.

[0038] The processor receives a force signal from the strain gauge 36 indicating the magnitude and direction of the three-dimensional (3D) force from the distal end assembly 14 on the strain gauge. The strain gauge 36 also provides a signal to the processor indicating the torque about the z-axis on the strain gauge, which is generated by the distal end assembly 14. Thus, the processor is able to determine the force and torque applied to the posts 134 of the platform 50 due to the twisting of the distal end assembly.

[0039] Actuator 114 twists shaft 16 about axis 122, and the splines of the distal end assembly apply a torque about the z-axis on the posts 134. This is the measured torque. The torque about the z-axis is the projection of the torque about axis 122, and these two torques are related by Equation (1):

[0040] T z = cosθ · T s (1)

[0041] where T z is the torque about the z-axis,

[0042] T s is the torque about the catheter axis 16 (i.e., axis 122), and

[0043] Θ is the angle between the z-axis and the catheter axis.

[0044] The angle Θ is illustrated in Figure 4 FIG.

[0045] Equation (1) can be rearranged as Equation (2):

[0046]

[0047] Using the position data received from the sensor 30 and the force and torque data received from the strain gauge 36, and using Equation (2), the processor 34 can form a correspondence between the position of the sensor 30 on the one hand and the 3D force and the torque about the catheter axis 16 on the distal end assembly 14 on the other hand. This correspondence can be generated from a look-up table of the raw data received when the system 10 is operating. Alternatively, this correspondence can be generated by fitting the raw data to a model applied to the distal end assembly in order to find the parameters of the model. In some examples, the spline 20 is elastic and the model is assumed to be an elastic model. Then, when using a catheter other than the catheter 18 in a procedure, this correspondence can be used to find the forces and torques of such a catheter. During the procedure, if the value of the torque is at a preset value, above which there may be a possibility that the distal end assembly may suddenly untwist, a warning that the preset value has been reached can be issued.

[0048] Examples

[0049] Example 1. An apparatus for calibrating a catheter (18), the apparatus comprising:

[0050] A base (42) defining a first axis (z) orthogonal to the base;

[0051] A frame (98) coupled to the base and configured to rotate about a second axis (102) orthogonal to the first axis;

[0052] A catheter support (118) coupled to the frame and configured to hold the catheter and to rotate the catheter about a third axis (122) orthogonal to the second axis; and

[0053] An instrument (36) coupled to the base and to the distal end assembly (14) of the conduit and configured to provide an indication of a force on the distal end assembly in response to translation of the distal end assembly along the first axis.

[0054] Example 2. The apparatus according to Example 1, and the apparatus includes an actuator coupled to the frame and configured to rotate the frame about the second axis.

[0055] Example 3. The apparatus according to Example 1, and the apparatus includes an actuator coupled to the frame and configured to rotate the conduit about the third axis.

[0056] Example 4. The apparatus according to Example 1, and the apparatus includes an actuator coupled to the base and configured to provide translation of the distal end assembly along the first axis.

[0057] Example 5. The apparatus according to Example 4, and the apparatus includes a movable base configured to act as a lever, and wherein the actuator is configured to apply a force on the movable base to apply the force on the distal end assembly.

[0058] Example 6. The apparatus according to Example 5, wherein the movable base is configured as a class 1 lever.

[0059] Example 7. The apparatus according to Example 5, and the apparatus includes a cam coupled to the movable base, and wherein the actuator is configured to rotate the cam to apply the force.

[0060] Example 8. The apparatus according to Example 1, and the apparatus includes a platform that connects the instrument to the distal end assembly and is configured to support the distal end assembly.

[0061] Example 9. The apparatus according to Example 8, the apparatus includes a plurality of pins protruding from the platform, the plurality of pins being configured to hold the distal end assembly in a preset position on the platform.

[0062] Example 10. The apparatus according to Example 1, and the apparatus includes a positioning pad positioned near the base and configured to transmit electromagnetic radiation to the conduit and the distal end assembly, and wherein the electromagnetic radiation is configured to generate a signal in at least one sensor connected to at least one of the conduit and the distal end assembly, wherein the signal indicates the position of the at least one sensor.

[0063] Example 11. The device according to Example 1, wherein the instrument is configured to provide a further indication of the torque about the first axis on the distal end assembly in response to rotation of the catheter about the third axis.

[0064] Example 12. The device according to Example 11, and the device includes a processor configured to calculate an angle between the first axis and the third axis, and calculate another torque about the third axis on the distal end assembly in response to the angle and the indication of the torque about the first axis.

[0065] Example 13. The device according to Example 1, wherein the first axis, the second axis, and the third axis intersect at a common point.

[0066] Example 14. The device according to Example 1, and the device includes a torque meter coupled to the catheter support and configured to provide a further indication of the torque about the third axis in response to rotation of the catheter about the third axis.

[0067] Example 15. A method for calibrating a catheter (18), the method comprising:

[0068] Providing a base (42) that defines a first axis (z) orthogonal to the base;

[0069] Coupling a frame (98) to the base and configuring the frame to rotate about a second axis (102) orthogonal to the first axis;

[0070] Coupling a catheter support (118) to the frame and configuring the catheter support to hold the catheter and rotate the catheter about a third axis (122) orthogonal to the second axis;

[0071] Coupling an instrument (36) to the base and to the distal end assembly (14) of the catheter; and

[0072] Configuring the instrument to provide an indication of the force on the distal end assembly in response to translation of the distal end assembly along the first axis.

[0073] Example 16. The method according to Example 15, and the method includes coupling an actuator to the frame and configuring the actuator to rotate the frame about the second axis.

[0074] Example 17. The method according to Example 15, and the method includes coupling an actuator to the frame and configuring the actuator to rotate the catheter about the third axis.

[0075] Example 18. The method according to Example 15, and the method includes coupling an actuator to the base and configuring the actuator to provide translation of the distal end assembly along the first axis.

[0076] Example 19. The method according to Example 18, and the method includes configuring the movable base to act as a lever, and wherein the actuator is configured to apply a force on the movable base to apply the force on the distal end assembly.

[0077] Example 20. The method according to Example 19, wherein the movable base is configured as a class 1 lever.

[0078] Example 21. The method according to Example 19, and the method includes coupling a cam to the movable base, and wherein the actuator is configured to rotate the cam to apply the force.

[0079] Example 22. The method according to Example 15, and the method includes connecting the instrument to the distal end assembly by a platform configured to support the distal end assembly.

[0080] Example 23. The method according to Example 22, and the method includes providing a plurality of pins protruding from the platform, the plurality of pins being configured to hold the distal end assembly in a preset position on the platform.

[0081] Example 24. The method according to Example 15, and the method includes positioning a positioning pad near the base and configuring the pad to transmit electromagnetic radiation to the catheter and the distal end assembly, and wherein the electromagnetic radiation is configured to generate a signal in at least one sensor connected to at least one of the catheter and the distal end assembly, wherein the signal indicates the position of the at least one sensor.

[0082] Example 25. The method according to Example 15, wherein the instrument is configured to provide a further indication of the torque about the first axis on the distal end assembly in response to rotation of the catheter about the third axis.

[0083] Example 26. The method according to Example 25, and the method includes calculating an angle between the first axis and the third axis, and calculating another torque about the third axis on the distal end assembly in response to the angle and the indication of the torque about the first axis.

[0084] Example 27. The method according to Example 15, wherein the first axis, the second axis, and the third axis intersect at a common point.

[0085] Example 28. The method according to Example 15, and the method includes coupling a torque meter to the catheter support, and configuring the torque meter to provide a further indication of the torque about the third axis in response to rotation of the catheter about the third axis.

[0086] The above examples are cited by way of illustration, and the present disclosure is not limited to what is specifically shown and described above. On the contrary, the scope of the present disclosure includes combinations and sub - combinations of the various features described above, as well as their variations and modifications, which will occur to those skilled in the art upon reading the above description and which are not disclosed in the prior art.

Claims

1. An apparatus for calibrating a catheter, the apparatus comprising: a base defining a first axis orthogonal to the base; a frame coupled to the base and configured to rotate about a second axis orthogonal to the first axis; a catheter support coupled to the frame and configured to hold the catheter and rotate the catheter about a third axis orthogonal to the second axis; and A meter is coupled to the base and to a distal tip assembly of the catheter and is configured to provide an indication of a force on the distal tip assembly in response to translation of the distal tip assembly along the first axis. 2 . The apparatus of claim 1 , further comprising a first actuator coupled to the frame and configured to rotate the frame about the second axis. 3 . The apparatus of claim 1 , further comprising a second actuator coupled to the frame and configured to rotate the catheter about the third axis.

4. The apparatus of claim 1, further comprising a third actuator coupled to the base and configured to provide translation of the distal tip assembly along the first axis.

5. The device according to claim 4, further comprising: a movable base, wherein the movable base is configured as a Class 1 lever; and A cam is coupled to the movable base, and wherein the third actuator is configured to rotate the cam to apply the force.

6. The device according to claim 1, further comprising: a platform coupling the instrument to the distal tip assembly and configured to support the distal tip assembly; and A plurality of pins protrude from the platform and are configured to retain the distal tip assembly in a preset position on the platform.

7. The apparatus of claim 1, further comprising a positioning pad positioned adjacent to the base, configured to transmit electromagnetic radiation to the catheter and the distal tip assembly, and wherein: The electromagnetic radiation is configured to generate a signal in at least one sensor connected to at least one of the catheter and the distal tip assembly, wherein the signal is indicative of a position of the at least one sensor.

8. The device according to claim 1, wherein: The meter is configured to provide a further indication of torque on the distal tip assembly about the first axis in response to rotation of the catheter about the third axis.

9. The device of claim 8, further comprising a processor configured to calculate an angle between the first axis and the third axis, and to calculate another torque on the distal end assembly about the third axis in response to the angle and the indication of the torque about the first axis.

10. The apparatus of claim 1 and comprising a torque meter coupled to the catheter support configured to provide a further indication of torque about the third axis in response to rotation of the catheter about the third axis.

11. A method for calibrating a catheter, the method comprising: providing a base, the base defining a first axis orthogonal to the base; coupling a frame to the base and configuring the frame to rotate about a second axis orthogonal to the first axis; coupling a catheter support to the frame and configuring the catheter support to retain the catheter and to rotate the catheter about a third axis orthogonal to the second axis; coupling a meter to the base and to a distal end assembly of the catheter; as well as The meter is configured to provide an indication of a force on the distal tip assembly in response to translation of the distal tip assembly along the first axis. 12 . The method of claim 11 , further comprising coupling a first actuator to the frame and configuring the first actuator to rotate the frame about the second axis.

13. The method of claim 11, further comprising coupling a second actuator to the frame and configuring the second actuator to rotate the catheter about the third axis.

14. The method of claim 11, further comprising coupling a third actuator to the base and configuring the third actuator to provide translation of the distal tip assembly along the first axis.

15. A method according to claim 14 and comprising the movable base being configured as a level 1 lever and coupling a cam to the movable base and wherein, The third actuator is configured to rotate the cam in order to apply the force.

16. The method according to claim 11, further comprising: connecting the meter to the distal tip assembly via a platform configured to support the distal tip assembly; as well as A plurality of pins are provided projecting from the platform and configured to retain the distal tip assembly in a preset position on the platform.

17. The method of claim 11, further comprising positioning a positioning pad adjacent to the base and configuring the pad to transmit electromagnetic radiation to the catheter and the distal tip assembly, and wherein: The electromagnetic radiation is configured to generate a signal in at least one sensor connected to at least one of the catheter and the distal tip assembly, wherein the signal is indicative of a position of the at least one sensor.

18. The method according to claim 11, wherein: The meter is configured to provide a further indication of torque on the distal tip assembly about the first axis in response to rotation of the catheter about the third axis.

19. The method of claim 18, further comprising calculating an angle between the first axis and the third axis, and calculating another torque on the distal tip assembly about the third axis in response to the angle and the indication of the torque about the first axis.

20. The method of claim 11, further comprising coupling a torque meter to the catheter support, and configuring the torque meter to provide a further indication of torque about the third axis in response to rotation of the catheter about the third axis.

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