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1. Authors: Fang, H. et al., Article: Capacitively Coupled Arrays of Multiplexed Flexible Silicon Transistors for Long-Term Cardiac Electrophysiology, Journal: Nat Biomed Eng., Date Published: Mar. 1, 2017.

2. Authors: Han et al., Article: Catheter-integrated soft multilayer electronic arrays for multiplexed sensing and actuation during cardiac surgery, Journal: Nature Biomedical Engineering, Date Published: Sep. 7, 2020.

3. Author: Hastings, PhD from the Royal College of Surgeons in Ireland, Article: Soft Electronics for Advanced Heart Catheters, Website: Medgadget, Date Published: Sep. 8, 2020.

4. Organization: SCIENCE Codex, Article: New surgical tools with smart sensors can advance cardiac surgery and therapy, Date Published: Sep. 7, 2020.

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Soft Electronics for Advanced Heart Catheters Summary 

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Soft Electronics for Advanced Heart Catheters Summary 

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Currently, the heart catheters being used for minimally invasive cardiac procedures, such as ablations, have a certain rigidity that makes it difficult for surgeons to navigate the heart and blood vessels. As a result, the use of multiple catheters may be required, leading to unnecessary, potential risks (Hastings, 2020). In an effort to remedy this dilemma, Engineers at the George Washington University and Northwestern University have discovered how to combine medical instruments with an advanced soft electronics system. In other words, they have developed a way to apply stretchable/flexible matrices (i.e., electrode sensors, actuators, temperature sensors, and pressure sensors) to a balloon heart catheter. This in turn improves the fluidity through which surgeons can navigate the heart and blood vessels without the use of multiple catheters (SCIENCE Codex, 2020).

IMAGE: Seen here, an inflated balloon catheter affixed with a multitude of electrode sensors.
Image: John Rogers/Northwestern University

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Traditional ablation procedures often require the use of multiple X-rays to help guide the catheter to its destination. Soft electronic arrays on balloon catheters allows the balloon to conform with soft-tissue surfaces. As a result, these flexible electronic arrays allow for various types of spatiotemporal mapping, including temperature, pressure, and electrophysiological parameters, thereby eliminating the need for potentially harmful radiographic imaging (Han et al., 2020).

MEDIA: Seen here, electrogram mapping on a human heart.
Media: Han, M. et al./George Washington and Northwestern University

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Additionally, according to Han, M. et al., the flexible, electronic arrays on endocardial balloon catheters allow for... "programmable electrical stimulation, radiofrequency ablation and irreversible electroporation" (2020). As a result, surgeons will be able to locate life threatening arrhythmias more easily and ablate the cells causing said arrhythmias with more accuracy. Furthermore, the sensors and actuators atop these balloon catheters are capable of delivering pharmaceuticals and other biomaterials into cells via reversible electroporation (SCIENCE Codex, 2020).

MEDIA: Seen here, temperature mapping during radiofrequency ablation.
Media: Han, M. et al./George Washington and Northwestern University

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The use of smart sensors in balloon catheters to aid in minimally invasive cardiac procedures is extremely new to the field of medicine; therefore, it stands to reason the long-term outcomes of using such a device are unknown. In terms of the mechanics of the device itself, because of all the electrical and multifaceted components, there is a risk of biological fluids penetrating into the electronics, resulting in an electrochemical reaction. However, studies have already demonstrated the efficiency of leakage-free coverings to significantly decrease this risk (Fang et al., 2017). Additionally, there are certain scenarios in which the balloon catheter could trigger an inflammatory response, resulting in damage to the tissue and the device. However, modified hydrogels may be used to reduce this risk (Fang et al., 2017).

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As was previously mentioned, the current models of catheters being used today retain a rigidity that makes it difficult for the catheter to conform with soft-tissue surfaces, impeding its maneuverability. Additionally, they sometimes require potentially harmful radiographic imagery to help guide the catheter. However, heart catheters combined with advanced electronic functionality improves the fluidity of movement by allowing the catheter to sense different pressures, temperatures, etc... as it is being guided through the soft-tissues. Furthermore, the mapping features of the electrical sensor arrays provide real-time feedback, reducing the need for other types of imagery (SCIENCE Codex, 2020).

It is therefore this author's opinion that smart sensors
combined with epicardial balloon catheters could greatly improve the field of
minimally invasive cardiac procedures. It demonstrates potential to reduce
procedural time as well as reducing the risk for perforation. Furthermore, it
demonstrates higher accuracy at identifying and treating potentially
life-threatening arrhythmias. Hopefully, this will improve ablation success
rates, helping patients maintain a normal sinus rhythm. Overall, this author is
excited to see how this new product will shape the field of medicine as a
whole.

IMAGE: Seen here, a deflated balloon catheter affixed with a multitude
of electrode sensors.
Image: John Rogers/Northwestern University

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Using Strengths - Coordinating the Best Team

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Using Strengths - Coordinating the Best Team

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This author's top five strengths as determined by the GALLUP: CliftonStrengths questionair are as follows: Achiever/Responsibility/Harmony/Relator/Learner.
As leader of the evaluation team for this innovative device (catheter-integrated soft multilayer electronic arrays for minimally invasive cardiac procedures), this author will choose five other members to help in researching this project based on their Strengths. This author would like someone with the Analytical strength to review all the factors of this complex device and other ways it could impact cardiac surgery. This author would choose someone with the Arranger strength to maximize the team's productivity and research organization. The Arranger can also help present the research knowledge gained in an organized fashion. Someone with the Communication strength would be desired to help with any miscommunications amongst team members as well as to help present the project findings to the facility once complete. This author would find someone with the Focus strength to help complete miscellaneous tasks and research. Lastly, this author would choose someone with the Positivity strength to help keep everyone motivated throughout the duration of the project. As a result, this author would choose Angelica, Abraham, Carter, Fernando, and Pablo to be on his evaluation team.

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Fang, H., Yu, K. J., Gloschat, C., Yang, Z., Chiang, C.-H., Zhao, J., … Rogers, J.
(2017). Capacitively Coupled Arrays of Multiplexed Flexible Silicon
Transistors for Long-Term Cardiac Electrophysiology. Nature Biomedical
Engineering. doi:10.1038/s41551-017-0038
Han, M., Chen, L., Aras, K., Liang, C., Chen, X., Zhao, H., … Rogers, J. A. (2020).
Catheter-integrated soft multilayer electronic arrays for multiplexed sensing
and actuation during cardiac surgery. Nature Biomedical Engineering.
doi:10.1038/s41551-020-00604-w
Hastings, C. (2020, September 8). Soft Electronics for Advanced Heart Catheters.
Medgadget. Retrieved October 5, 2020, from
https://www.medgadget.com/2020/09/soft-electronics-for-advancedheart
catheters.html
SCIENCE Codex. (2020, September 7). New surgical tools with smart sensors can
advance cardiac surgery and therapy. Retrieved October 5, 2020, from
https://www.sciencecodex.com/new-surgical-tools-smart-sensors-can-
advance-cardiac-surgery-and-therapy-655829