6150 Impulse Dynamics and Watchman Intro

Impulse dynamics device has to utilize ______ _______ ________; commonly implanted on the _____ side because patients already have ____; it does not _______ _______, it delivers ___ _____ sessions; it is _____ voltage and paces in the ______ of the ____ for ___ms; this device uses a lot of juice, so it is ________

other companies’ leads; right; PPM; constantly pace; one hour; high; middle; QRS; 30; rechargable

impulse dynamics is used for ______ ________ patients to ________ their symptoms and reverse structural remodeling; how it works: it ________ the heart in the middle of the ___ to increase ____ in the cells and improve ________ without increasing _____

heart failure; improve; stimulates; AP; Ca++; contractility; MVO2

one thing another company can do for CAD is to put _______ on the _____ that inflate during _______ to increase ____ which increases ____ which is important for CABF; it is synched to the ____ and occurs right after the ____ during the ___ wave; this is used on patients with chronic ______ ______ that is not due to a pin-pointed vessel occlusion; this is called _____ (________ ________ __________)

cuffs; legs; diastole; PVR; DBP; ECG; QRS; T; chest pain; EECP; enhanced external counterpulsation

why do interventional cardiologists not like this?

it treats the symptoms but not the cause; patients will feel better but the issue progresses; this can continue to the point where the patient is no longer a candidate for a stent

1st generation =

2nd generation =

3rd generation =

watchman; watchman flex; watchmen pro flex

big change between watchman and watchman flex

the original did not have close back and had spikes that could perf

the flex can be in a _____ formation; it has ____ rows of anchors instead of 1; they are like little ______ that stick out; the original could only be fully ___ or fully __, but the flex has this ___-______ formation; even in this formation, the ______ still stick out

ball; two; barbs; out; in; in-between; anchors

the design goals of the pro:

1. reduce device related ________

2. post-approval _________ study

3. reduce _________ LAAs

4. improve _____ performance

thrombus; monotherapy; untreatable; seal

the pro features _______ technology to reduce _______

hemocoat; thrombus

pro is designed to enhance the ________ process and optimize _____ for more patients; the watchman _______ helps deliver it; there is a ___-_________ coating to reduce the severity of acute _____ ______ response; it is ___mm in size (they expanded the matrix to treat _____ _____ of patient anatomies); _________ markers to increase fluoro visibility for ______ and _______ (those are the ___ _____ on the device)

healing; LAAC; platform; non-thrombogenic; foreign body; 40; largest range; radiopaque; positioning and deployment; 3 dots

the hemocoat technology showed:

1. less ______ _______

2. less _______

3. less ______

platelet biding; inflammation; thrombus

in the US, it is watchman vs ________ (from the company _____) but in Europe there are many companies

Amulet; Abbott

the radiopaque markers are _____ spaced ___________, located at the plane of ________ ________ for optimal _______ performance

evenly; circumferentially; maximum diameter; sealing

FDA approved PASS criteria:

position, anchor, size, seal

regarding size, we want the device to be ________ than the os so there is some ________ holding it there; previously, the size was only ___mm and many times to get a good seal, they would have to put the device more _______ within the LAA, still leaving space where ______ can form; now the size is ___mm to hopefully increase the optimal patient group

larger; tension; 35; distally; clots; 40

Amulet uses the acronym ________ to walk through the procedure

CLOSE

JnJ has some devices called _________ and _________; their acronym is ______

wavecrest and laminar; SEAL

when did watchman get FDA approved? ____

when was the first implant? ____

2015; 2002

the drug polymer that is on the watchman is ____-___ to reduce clots

PVDF-HFP