Introduction

In previous chapters, authors provided brief histories of cardiac device development and several fairly thorough discussions of currently employed devices or assessment technologies. To gain insight into how rapidly innovations in the area of cardiac disease are progressing, a search of the US Patent and Trademark Office Website (www.uspto.gov) can simply be searched. Such a search produces an impressive number of companies or individuals attempting to secure intellectual property protection in this clinical category. More specifically, the following are the numbers of published patent applications, identified in November 2004, citing the following key words:

• cardiac (18,920 patent applications)

• cardiac surgery (1015 patent applications)

• cardiology (1480 patent applications)

• cardiac electrophysiology (79 patent applications)

• cardiovascular stents (52 patent applications)

• cardiac repair (32 patent applications)

This does not include all issued patents to date, many of which detail prospective future products. For example, in searching the same database, the key word "cardiac" produces 37,410 issued patents to date since 1976. There are several other places to locate information on up-and-coming cardiac devices, such as the Food and Drug Administration Website (http:// www.fda.gov/) or websites listed at the end of this chapter.

It should be mentioned that many novel ideas that eventually lead to new products, therapies, or training first occur through basic cardiac research. For emerging technologies to continue to advance at a rapid rate, it is imperative that laboratories performing basic research in such technological areas continue to receive necessary support. Furthermore, prototype testing and clinical trials are essential to ensure that the best possible technologies are both developed and eventually made available for general use. Yet, it is important to note that many lessons can be learned from trials that employed either misdirected devices or technologies.

The primary goals of this last chapter are to: (1) discuss, in more detail, some of the aforementioned technologies; (2) introduce several additional technological advances associated with

Autopulse Carry Case

Fig. 1. Various compression-decompression devices. (A) The LifeStick™ Resuscitator is an investigational, noninvasive, manually powered cardiopulmonary resuscitation (CPR) device, invented and designed by Datascope Corporation (Montvale, NJ), that is designed to enhance circulatory perfusion by facilitating sequential phased active compression and decompression of the chest and abdomen. (B) The AutoPulse Resuscitation System consists of a portable AutoPulse Platform, a single-patient use LifeBand™, rechargeable batteries, battery charger, and carrying case (Revivant Corp., Sunnyvale, CA).

Fig. 1. Various compression-decompression devices. (A) The LifeStick™ Resuscitator is an investigational, noninvasive, manually powered cardiopulmonary resuscitation (CPR) device, invented and designed by Datascope Corporation (Montvale, NJ), that is designed to enhance circulatory perfusion by facilitating sequential phased active compression and decompression of the chest and abdomen. (B) The AutoPulse Resuscitation System consists of a portable AutoPulse Platform, a single-patient use LifeBand™, rechargeable batteries, battery charger, and carrying case (Revivant Corp., Sunnyvale, CA).

Impedance Threshold Device
Fig. 2. Shown is the impedance threshold device ResQPod™, distributed by Zoll Medical (Chelmsford, MA). Used with permission from the ZOLL Medical Corporation Website. © 2004.

cardiovascular health care that have been recently introduced or are currently in clinical testing or soon to be released; and (3) discuss future opportunities in the cardiac device arena. It should be noted that other areas of importance in cardiac treatment, such as biological approaches to disease management (e.g., stem cell therapy), genomics (i.e., diagnostics and gene therapy), proteomics, and tissue engineering will also have a major impact on the future of cardiac clinical care; however, detailed discussions of these approaches are beyond the scope of this text. More specifically, this last chapter reviews several innovations in each of the following areas: (1) resuscitation systems and devices; (2) implantable therapies; (3) delivery systems; (4) invasive therapies; (5) procedural improvements;

(6) less-invasive surgical approaches; (7) postprocedural follow-ups; and (8) training tools.

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