H.23 The IntraCorporEal Cardiac Arrest Pharmaceutical (ICECAP) Device

Title:

Developing the most efficient method to enable pharmaceutical delivery acutely and remotely.

Specialty:

Cardiac Electrophysiology

Problem:

Cardiac arrest is the most time sensitive issue in the field of arrest. Decisions can often be made in seconds, but executing those decisions are often a barrier in managing cardiac arrest and becomes an arduous process. Those who are in the medical setting can be monitored closely and be addressed accordingly. However many experience cardiac arrest outside of a medical setting and often it becomes too late to intervene by the time they do arrive at one.

Background:

Patients may go into cardiac arrest unpredictably, for many reasons, most of which aren’t fully understood. There are cardiac arrest algorithms established by the American Heart Association as part of the Advanced Cardiac Life Support (ACLS) guidelines that guides clinicians and healthcare staff what to do in the event that cardiac arrest ensues, which consists of using electricity as well as pharmaceuticals.

Pacemakers and intracardiac defibrillators can pace and shock hearts, respectively, on a remote and immediate basis. They are implanted with minimal complications to help control arrhythmias a patient may experience (from an electrical standpoint). Using this analogy, it should also be feasible to provide pharmaceutical intervention in the same manner. 

Target population:

Any patient at risk for arrhythmias/cardiac arrest.

Symptoms prevented/treated:

Cardiac arrest

Coma

Death

Current methods:

ACLS guidelines whose use is limited to a hospital setting.

• https://cpr.heart.org/en/?ReturnUrl=%2fresuscitation-science%2fcpr-and-ecc-guidelines%2falgorithms
•  

Auto-injector devices, such as an epi-pen.

• https://journals.sagepub.com/doi/10.1177/0300060520926019?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
• Pros: quick, patient can use themselves
• Cons: not intracorporeal. Can’t detect cardiac arrest/arrhythmias

Clinical vision:

To provide a patient at risk for cardiac arrhythmias with an intracorporeal pharmaceutical reservoir that can be activated and injected automatically when an abnormal cardiac rhythm is detected.