Report (Rewrite)

Table of Contents.

Abstract.................................................................................................... (iii)

Introduction............................................................................................... (iv)

Chapter one;

Cardioinsight Tech. Inc..................................................................................

Overview of how the CardioInsight’s ECVUE mapping system operates and function.

Causes and Conditions of AF............................................................................

How to Treat AF- Atrial fibrillation..................................................................

History of Cardioinsight Tecn. Inc.....................................................................

Executive Officers of Cardioinsight..................................................................

CHAPTER 2.

INTERNSHIP DISCRIPTION;........................................................................

OVERVIEW OF INTERSHIP...........................................................................

CHAPTER 3.

S.W.O.T ANALYSIS......................................................................................

CHAPTER 4.

Recommendations.................................................................................................

Abstact.

This report desribe the intership that i spend in Cardioinsight, it is known and famous world-wide by their discovery of a new medical device used for diagnosis and treatment of heart diseases. I have describe how Cardisinsight uses it's medical devices to commercialize a breakthrough technology which is built to help enhance the diagnosis and the treatment of electrical disorders of the heart.

After understanding how the machine operates, i was able to explain how they are used in the hospitals during the diagnosis and the treatment of a patient, I even further explain in details how these machines operates and moreso, i have identified the causes of heart disorders and diseases and how they can be cured or controlled using CardioInsight's ECVUE.

Introduction.

This internship report is based on the knowledge i have acquired and experienced while in CardioInsight as an intern. I decided to do my internship in Cardioinsight since it is known world-wide with the kind of medical devices and systems they have which have unique ability in diagnosis and treatment guidance of heart diseases.

During my intership, i learned the importance of obtaining a basic working knowledge of the normal anatomy and physiology of the organ that is affected by a need in that it establishes a baseline against which abnormalities are understood. This research also provided me with an understanding of important vocabulary and context as I delved into further research. The disease is much easier to comprehend if the anatomy of the affected organ or organ system is clearly understood and can be visualized.

Once I learned about normal patterns of function within an affected area, I had a basis for understanding how the disease functions.

As proposed by my supervisor, Kevin Mendelsohn, vice-president of the company and in charge of finance & corporate development, that I work on a project that would culminate in the generation of a business plan to detail and quantify the value of our mapping system for atrial fibrillation (a certain type of arrhythmia) mapping, include detailing the unique clinical applications of the system, quantifying the patient populations, analyzing the competition, evaluating the pricing structure, and ultimately generating a "value" of the opportunity.

My mission was to be based for one half in Bordeaux, in order for me to work with the CHU, one of the leading centers working with the company, and the other half in the head office in Cleveland to finalize the project.

During my intership, i spend the first few days of my internship at the hospital in assisting to some cases and see the product in action.

The first patient I saw was a 45 years old man who was to be ablated for a Wolff–Parkinson–White syndrome (WPW), one of several disorders of the conduction system of the heart that are commonly referred to as pre-excitation syndromes. While the majority of individuals with WPW remain asymptomatic throughout their entire lives, there is a risk of sudden cardiac death associated with the syndrome. While at the hospital I was following Sandra, the CardioInsight employee conducting ECVUE cases everyday with the physicians of the Haut-Leveque hospitalin Pessac. We went to the patient’s room before he was sent down to the CT scan, when she explained the technique to him and asked for his authorization, since the product is still in the clinical testing phase. He was quite interested, asked questions about the system, and approved. He even asked me to take a picture with the vest on for his kids!

I found the installation very easy. Two cables provide a link between the vest and the system’s central unit. Sandra realized a segmentation of the scan images, in the operating room before the physician arrived, and the located the area of the bundle of Kent responsible for the arrhythmias after the software generated the 3D visualization. I was simply amazed. Then the physician arrived and punctured soon after having seen the 3D map. 20 minutes later, she had the ablation catheter in the area of concern, and after 5 seconds, the pre-excitation had disappeared on the monitor. That’s when I really realized the capacity of the system to make everything easier for both the patient and the physicians.

The second case was an aged woman with tachycardia. She was mapped using ECVUE in the operating room, and was ablated without a break as well.

The third patient was about 45 and suffered from paroxysmal ventricular tachycardia (VT) since the age of 25. He had an ICD, changed 2 times. They had recorded that the VT was preceded by a short series of extrasystoles. The system was here to be used to map the electrical activity of the heart during that very first extrasystole, in the patient’s room. Given the earliness of the disorder, he was used to the various other techniques, and was also intrigued by this new vest and the mapping. The physician attempted to trigger the VT by stimulation using the programmer of the ICD. 4 or 5 morphologies of extrasystole came out, which they had to settle for, but never the one that led to the VT.

Another invasive 3D mapping system of 2 catheters, one for the endocardium and one for the epicardium, was used the day after on this same patient, who as a result, spent half a day on the table.

The last case was a patient who needed an ICD implantation. As mentioned in the product section, ECVUE can also be used in CRT patients notably regarding patient selection, device lead placement and programing optimization. But this operation was quite unique in that a new sophisticated robotic platform, the da Vinci System, was here to be used for CRT implantation for one of the first times in Europe.With da Vinci, small incisions are used to introduce miniaturized wristed instruments and a high-definition 3D camera, helping doctors to take surgery beyond the limits of the human hand. Kevin, my supervisor, suggested that I assisted to the procedure to measure the feasibility of a joint utilization with ECVUE.

CHAPTER ONE: CardioInsight medical devise Company.

Overview of how the CardioInsight’s ECVUE mapping system operates and function.

This system has a unique ability of making the diagnosis, treatment guidance of heart disorders and diseases e.g cardiac arrhythmias and heart failure to be simpler, faster, and safer.

CardioInsight's ECVUE has;

1. a vest that collects body surface electrical signal, which are used ones and also are disposable.

2. A visual Workstation which is advanced in data analysis hence produces a 3D images of the heart's electrical activity.

And the good news is that ECVUE is available commercially in Europe for helpimg electrophysiologists with cardiac arrhymias diagnosis.

I found out that Atrial fibrillation which is also known by the abbreviation AF, is the most common type of arrhythmia. An arrhythmia can be identified with the rate or rhythm of the heartbeat. When a person suffers from an arrhythmia, his heart can be too fast, slow, or either an irregular rhythm.

Causes and Conditions of AF,

According to my research, i did found out there are many factors and conditions that is associated with AF.

These includes; diabetes mellitus, ageing, obesity, emotional and physical stress e,t,c.

AF patients can be classified into five different classes namely; 1st diagnosed, paroxysmal, persistent, long-standing persistent and permanent AF.

How to Treat AF- Atrial fibrillation.

The goal of any treatment is to improve outcomes in those patients with a disease or disorder. Treatment analysis involved detailed research to understand what established and emerging therapies exist, how and when they are used, how and why they work, their effectiveness, and their economics. This analysis also provided me with an understanding of the clinical and patient-related requirements that any new treatment must meet to be equivalent or superior to existing alternatives. It further establishes a baseline of knowledge against which the uniqueness and other merits of ECVUE can be evaluated.

Usually there are two ways of treating AF by use of drugs, this can either be through;

1. Rate control.

2. Rhythm control.

RATE CONTROL.

This reduces the heart rate to normal, which is usually in normal cases 60-100bpm'.This is all about reducing the effect of AF on the ventricular rate by the prescribed medicines which will thereafter increase the degree of block at the level of the AV and also reduce the number of impulses that operates into the ventricles.

RHYTHM CONTROL.

This is all about doing away wid AF and maintaining Sr in a process called cardioversion. During the acute setting of AF, it is notable in the first diagnosis.

History of Cardioinsight Tecn. Inc.

CardioInsight is a medical device company, which was founded in 2006, by the some researchers from Case Western University, it's headquater is based in Cleveland, Ohio.

Executive Officers of Cardioinsight.

1.Chief Exercutive officers.

Mr. Patrick. J. Wethington.

2. Dr, Charu maranatha.

Co-founder and chief scientif policer,.

3. Mr. Kelvin Mildenson.

4. Mr christina Vacco.

Vice precident of Quality regulatory affairs and operati

5. Mr, James harridet

Vice precident of clinical Affairs.

CHAPTERS 2. INTERNSHIP DISCRIPTION;

OVERVIEW OF INTERSHIP.

When I was first proposed to the project, I just could not turn it down. I immediately saw the revolutionary aspect of ECVUE and was thrilled to work on it at such early stages. I must say that I got quite a good grasp of what a biomedical start-up can be, how it performs and what challenges it must overcome on a daily basis.

At first, the amount of information was quite overwhelming, given that I had no background in the field, and the fact that most of the information I needed was to be extracted from studies in English written by physicians, for physicians. But after a while I became familiar with the vocabulary and concepts, and could focus on delivering a high-quality report.The theoretical knowledge in Marketing and Business Planning that I gathered during two years has proved to be very useful, mostly regarding methodology of research.

As mentioned previously, my mission was supposed to be based for one half in Bordeaux, in order for me to work with the CHU in the first place, and the other half in the head office in Cleveland to finalize the project. Unfortunately, my supervisor took last minute vacation for 2 weeks in August. This resulted in an internship almost completely from home, by correspondence. While it enabled me to learn how to work independently, using only technology to communicate with the firm, I missed the relational side of the experience.

Besides, the procedures I was given the opportunity to attend were fascinating. I have always been interested by technology and innovations, especially in the medical field, and I realize that seeing this kind of operations was a unique chance.

Overall, this internship at CardioInsight this year has been very rewarding on many levels, and I am pleased to say that my contract was extended for at least another month, outside the internship framework.

CHAPTER THREE.

SWOT ANALYSIS.

Heart disease is the leading cause of death in United state, and because of bad diagnosis due to poor machines, it has lead to an increae of burden to the healthcare sector and at the same time loss of lives due to poor prescription of drugs and diagnosis.

Before 2006, Many hospital were using cardial mapping to diagnosize heart deseases and treatments but unfortunately due to limitations it has, a new discovery was made to replace it and now, hospitals or healthcare facilities tries to use Cardioinsight to carry out the heart deseases diagnosis and treatment which is much better and efficient that cardiac mapping.

Cardiac Mapping had so many limitations i.e.

1. it was time consuming during its procedure.

2. Could not provide the whole picture of hearts' electical activity. It could only produce on side of it.

3. Healthcare Professionals really find it hard to interprete the mapping information of the heart electrical activity.

CHAPTER FOUR;

Recommendations.

Therefore, CARDIOINSIGHT has a responsibility to motivate and encourage other healthcare facilities to use the machine device and stop usingh cardiac mapping for diagonising and treating heart diseases.

And at the same time, educate the health proffesionals on how to use their devices.

Since they are best know for there efficient machine device for diagnosis and treatment of heart deseases, they should look for a way to distribute there machines world-wide so that everyone can reach for medication of heart deseases and on time.