H.2 Transesophageal Electrical Cardioversion Device

Atrial fibrillation is a common cardiac arrhythmia. The prevalence of AF is 2.3% in people older than 40 years and 5.9% in those older than 65 years. Atrial fibrillation can cause significant morbidity and serious physical limitations. It can be converted to normal sinus rhythm with external direct current shock by applying patches connected to a shocking device called the defibrillator. During atrial fibrillation, clot can develop in the left atrium that can embolize and cause a stroke. To prevent such an event, especially if the individual has not taken anticoagulation regularly, a Transesophageal Echocardiography (TEE) is often performed immediately prior to shock or cardioversion, to rule any thrombi in the left atrium and its appendage. After the TEE which is performed under moderate sedation, the TEE probe is taking out and patient is given deeper level of sedation (deep sedation or monitored anesthesia care) and direct current synchronized external cardioversion is performed at 200-360J energy. This means that the patient needs to have two separate procedures with different levels of anesthesia with shock delivered at relatively high energy.

The objective of this project is to integrate the TEE procedure with cardioversion by delivering shock by transesophageal route instead of external route as a separate procedure. This would help shorten the procedure, require lighter sedation and lower energy shock (20-50J) and likely higher success rate due to proximity to the heart. The team working on this project will be tasked with designing a solution that interfaces with ultrasound imaging and defibrillator devices. Thus, a heavy focus on systems engineering and electrical engineering will be valuable.

Note: TEE probe is available to the mentor. Ultrasound machine compatible can be easily obtained.