Left Atrial Appendage Capture via Electrical Monitoring
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Solution Overview
Problem
Current minimally invasive procedures for closing the left atrial appendage are cumbersome, traumatic, and often require chest opening or transseptal penetration, posing risks and complications such as bleeding and thrombus formation, especially when attempting to visualize and access the slippery pericardial space for direct visualization and tissue capture.
Innovation Solution
The use of systems and methods that employ electrical activity monitoring and impedance measurement to navigate and capture the left atrial appendage through a sub-xiphoid approach, allowing for minimally invasive surgical navigation with steerable devices and force-limiting apparatus to ensure precise tissue capture and occlusion without the need for chest opening or transseptal penetration.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional minimally invasive procedures are used to access the pericardial space, then direct visualization and tissue capture can be achieved, but the procedure becomes cumbersome and traumatic requiring chest opening or transseptal penetration
Solution Approach 1:
The patent uses electrical activity monitoring as an intermediary to guide device navigation to the left atrial appendage. Instead of direct visual inspection requiring complex thoracoscopic setup, electrical signals serve as a mediator to identify tissue location and confirm capture, simplifying the access procedure while maintaining precision
Solution Approach 2:
The patent replaces mechanical visualization systems (thoracoscopes requiring chest opening) with electrical field-based detection. Electrical activity monitoring substitutes for mechanical intrusion, allowing navigation and tissue identification without physical chest opening or complex mechanical visualization equipment
2Reliability
If transseptal penetration is performed to access the left atrial appendage, then closure can be achieved, but bleeding and thrombus formation risks increase
Solution Approach 1:
Electrical activity monitoring serves as an intermediary to guide the device to the left atrial appendage from a safer access point. The electrical signals mediate the navigation process, allowing the device to reach the target without requiring transseptal penetration, thereby eliminating the associated bleeding and thrombus formation risks while maintaining closure effectiveness
Solution Approach 2:
The patent converts the challenge of accessing the slippery pericardial space into a benefit by using electrical activity as a tracking mechanism. The electrical signals, which normally would be difficult to detect in the fluid-filled pericardial space, become a useful guide to locate and secure the left atrial appendage without harmful penetration
3Measurement precision
If the pericardial space is accessed for direct visualization, then tissue capture can be performed, but the slippery nature of the space makes navigation difficult
Solution Approach 1:
Electrical activity monitoring acts as an intermediary navigation system that overcomes the slippery nature of the pericardial space. The electrical signals provide a reliable tracking mechanism that is not affected by the fluid environment, enabling precise navigation and tissue capture without being hindered by the slippery conditions
Solution Approach 2:
The patent implements feedback through real-time electrical activity monitoring during device navigation. The electrical signals provide continuous feedback on device position relative to the left atrial appendage, allowing operators to make precise adjustments and achieve accurate tissue capture despite the challenging slippery pericardial environment
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enables safe and precise minimally invasive closure of the left atrial appendage, reducing trauma and complications by providing direct visualization and precise tissue capture, while avoiding the risks associated with traditional methods.
Implementation Method 1
employ electrical activity monitoring and impedance measurement to navigate and capture the left atrial appendage
Implementation Method 2
employ electrical activity monitoring and impedance measurement to navigate and capture the left atrial appendage
Data Source
AI summary
Systems and methods capture and/or occlusion of selected body tissue using various tissue characteristics and/or techniques are described. In the context of left atrial appendage closure, the systems and methods can be used to capture the left atrial appendage while a closure instrument (suture, clip, ring, etc.) is placed over the appendage and tightened down or a closure method (ablation, cryogenic procedures, stapling, etc.) is performed to close the left atrial appendage.