Atrial assist device, a new alternative to lifelong anticoagulation?

Area of Science:

• Cardiovascular Science
• Biomedical Engineering
• Medical Devices

Background:

• Atrial fibrillation (AF) significantly increases stroke risk, often necessitating lifelong anticoagulation.
• Current treatments for AF may not fully restore atrial mechanical function, leading to persistent complications.
• Oral anticoagulation therapy carries risks of hemorrhagic complications.

Purpose of the Study:

• To evaluate the hemodynamic effects of a novel motorless volume displacing device (Atripump) for atrial assistance.
• To assess the potential of Atripump to prevent embolic events and improve atrial function.
• To explore Atripump as an alternative to long-term anticoagulation in AF patients.

Main Methods:

• A silicone-coated nitinol actuator (Atripump) was surgically attached to the external surface of the right atrium in five sheep.
• Hemodynamic parameters and intracardiac ultrasound data were recorded under baseline, AF, and Atripump-assisted AF (aaAF) conditions.
• The device was controlled by a pacemaker-like unit, and its effects on atrial function and thrombus formation were observed.

Main Results:

• Atripump assistance prevented thrombus formation in the atrial appendix in two animals.
• The device significantly improved atrial ejection fraction during assisted AF (20%) compared to AF alone (5%).
• Right atrial systolic surface area was maintained under aaAF (5.4 cm²) compared to baseline (5.2 cm²).

Conclusions:

• The Atripump effectively restores atrial mechanical function, mimicking the atrial "kick".
• This device demonstrates potential in preventing embolic events associated with atrial fibrillation.
• Atripump offers a promising alternative to long-term anticoagulation, potentially improving outcomes for heart failure patients.