NSF Award
2225386
The broader impact/commercial potential of this I-Corps project is the development of a catheter-based device that performs a targeted sympathetic nerve ablation to treat heart failure. Chronic heart failure is characterized by cardiac muscle weakening, which reduces the heart’s ability to pump blood to the rest of the body. To compensate, the nervous system diverts blood volume from the abdominal vasculature to help restore blood flow. While this mechanism is safely activated during normal periods of exercise in patients with heart failure, this mechanism over-stresses both the heart and lungs, causing fluid accumulation in the lungs. This fluid makes it difficult to breathe or carry out basic activities of daily living, forcing patients to the hospital multiple times each year. Current medications afford some clinical benefit but, in many cases, are ineffective at relieving symptoms or reducing hospital admissions. Heart failure remains a major clinical and economic burden with limited treatment options. The proposed technology leverages this neuro-cardiac mechanism, removing the fluid from the heart and lungs, and restoring it to a safer place — the abdominal capacitance vessels. This procedure may enable improved patient symptoms, reduced hospitalizations, and potentially alter the course of heart disease. By performing targeted ablation, the aim is to break the cycle of rehospitalizations for patients with heart failure.<br/><br/>This I-Corps project is based on the development of a device to perform an endovascular ablation that directs energy to tissues previously accessible only by invasive surgery for the interventionalist physician. Radiofrequency ablation has been employed to treat disease by coagulating tissues, but there remain concerns surrounding accuracy, procedure success, and collateral damage to surrounding tissues. The proposed technology relies on two components: 1) an electro-stimulation feature that locates a target nerve and confirms procedure completion and 2) a vein-puncture ablation probe that improves accuracy, reduces collateral damage, and reduces procedure times compared to conventional ablation catheters. The proposed device offers a solution for neuromodulation and nerve ablation that specifically targets nerves and avoids collateral damage. In addition, this minimally invasive device targets a nerve located in the thoracic cavity that is not near the heart. Therefore, cardiologists may consider this a low-risk procedure that may be performed in an outpatient setting. By targeting the highest risk heart disease patients, it may be possible to directly address the societal needs of patients and the healthcare system.<br/><br/>This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.
