Atrial assist device, a new alternative to lifelong anticoagulation?
Détails
Etat: Public
Version: Final published version
ID Serval
serval:BIB_8E95BD5D3DED
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Atrial assist device, a new alternative to lifelong anticoagulation?
Périodique
Swiss Medical Weekly
ISSN
1424-7860
Statut éditorial
Publié
Date de publication
2009
Peer-reviewed
Oui
Volume
139
Numéro
5-6
Pages
82-87
Langue
anglais
Résumé
OBJECTIVE: Atrial fibrillation is a very common heart arrhythmia, associated with a five-fold increase in the risk of embolic strokes. Treatment strategies encompass palliative drugs or surgical procedures all of which can restore sinus rhythm. Unfortunately, atria often fail to recover their mechanical function and patients therefore require lifelong anticoagulation therapy. A motorless volume displacing device (Atripump) based on artificial muscle technology, positioned on the external surface of atrium could avoid the need of oral anticoagulation and its haemorrhagic complications. An animal study was conducted in order to assess the haemodynamic effects that such a pump could provide. METHODS: Atripump is a dome-shape siliconecoated nitinol actuator sewn on the external surface of the atrium. It is driven by a pacemaker-like control unit. Five non-anticoagulated sheep were selected for this experiment. The right atrium was surgically exposed, the device sutured and connected. Haemodynamic parameters and intracardiac ultrasound (ICUS) data were recorded in each animal and under three conditions; baseline; atrial fibrillation (AF); atripump assisted AF (aaAF). RESULTS: In two animals, after 20 min of AF, small thrombi appeared in the right atrial appendix and were washed out once the pump was turned on. Assistance also enhanced atrial ejection fraction. 31% baseline; 5% during AF; 20% under aaAF. Right atrial systolic surfaces (cm2) were; 5.2 +/- 0.3 baseline; 6.2 +/- 0.1 AF; 5.4 +/- 0.3 aaAF. CONCLUSION: This compact and reliable pump seems to restore the atrial "kick" and prevents embolic events. It could avoid long-term anticoagulation therapy and open new hopes in the care of end-stage heart failure.
Mots-clé
Alloys, Animals, Anticoagulants, Atrial Fibrillation, Atrial Function, Right, Equipment Design, Heart-Assist Devices, Materials Testing, Sheep, Stroke, Thromboembolism
Pubmed
Web of science
Création de la notice
29/05/2009 11:33
Dernière modification de la notice
20/08/2019 15:52