Cardiac
Tissue sensing from inside the heart and vasculature.
One Platform, Adaptable Across Cardiac Procedures
Interventional cardiologists and electrophysiologists work inside the beating heart through catheters a few millimeters across, guided by fluoroscopy, CT planning and the feel of the instrument in their hands. The structures that decide the outcome, such as the conduction system, a vessel wall, the border of a lesion or the edge of the myocardium, often lie only millimeters from the catheter tip and are rarely visible on the images used to guide it.
Our goal is to enhance the cardiologist’s abilities by giving the catheter tip a live read of the tissue it touches, complementing imaging, reducing uncertainty and supporting safer, more precise procedures.
Below are five examples of how our emerging tissue intelligence platform can empower cardiac teams. They are examples, not a complete list.
TAVR — Conduction System Protection
Transcatheter aortic valve replacement pushes a new valve into the diseased aortic valve through the femoral artery. The His bundle and left bundle branch sit millimeters below the annular plane. Ruile et al. found the His bundle a mean of 5.3 ± 2.3 mm below the annulus and the left bundle branch origin 2.5 ± 2.2 mm below it, with standard deviations approaching the means themselves. Each additional millimeter of implant depth below the estimated His bundle raises the odds of permanent pacemaker implantation by 25% (odds ratio 1.25, 95% CI 1.14–1.39).
Thirty-day pacemaker rates run from under 5% to about 50% across series, with a median near 15% (Nuche et al., JACC: Cardiovascular Interventions, 2024). The STS/ACC TVT Registry shows 11.3% in 2020, down from 12.8% in 2016. New-onset left bundle branch block runs a median near 20%. Both are linked to higher long-term mortality and heart failure hospitalization.
Modifiable factors exist. Membranous-septum-guided high implantation in MIDAS-TAVR cut pacemakers from 9.7% to 3.0% and LBBB from 25.8% to 9.0% (Jilaihawi et al., JACC: Cardiovascular Interventions, 2019). But current guidance relies on CT planning and implant depth, not live tissue feedback at the catheter tip.
Arrhythmia Ablation — The Sense-Steer-Sense Loop
Radiofrequency catheter ablation for atrial fibrillation isolates the pulmonary veins. Single-procedure freedom from AF runs about 60–75% for paroxysmal cases; a 10-year series showed 58% after one procedure and 88% after multiple. Major complications run 1–5%. Deshmukh et al. reported 6.29% overall, 2.54% cardiac and 0.46% mortality (Circulation, 2013).
The core problem is border definition: you want to burn abnormal tissue and spare healthy myocardium, the esophagus and the phrenic nerve. TCP at the tip reads tissue conductivity in real time. Locate with TCP, electrify the same electrodes to ablate, then TCP again to confirm lesion extent and check for residual viable tissue. Reposition, repeat. No tool swap, no lost position.
The same loop that maps tumor margins in oncology maps ablation borders here.
Perforation Avoidance
The vessel wall has three layers: intima, media and adventitia. Blood impedance is far lower than that of the vessel wall and surrounding tissue, so a tip reading impedance continuously can detect the shift from lumen to wall to adventitia before mechanical force does. Iatrogenic arterial perforation during endovascular work is rare but potentially fatal.
Real-time bioimpedance sensing has already demonstrated detection of perivascular bleeding at a 4.8 ± 1.6% impedance change per cubic centimeter in animal models, well before clinical signs appear. Svendsen et al. showed impedance inversely tracks vessel cross-sectional area even with surrounding tissue present. Thermally drawn bioelectric catheters using tetrapolar impedance achieved 3 mm RMS target accuracy in surgeon navigation trials (Ranne et al., Advanced Intelligent Systems, 2026).
TCP extends that from geometry to tissue identity, flagging the adventitia before the tip breaches it.
Leadless Pacemaker Anchoring
Leadless pacemakers like Micra and Aveir must embed in the right ventricular myocardium to anchor. Perforation or effusion runs 0.44–1.6%: low in absolute terms, but the consequences are severe.
The FDA MAUDE database captured 563 Micra perforations between 2016 and 2021: 150 deaths (27%), 499 cardiac tamponades (89%) and 146 emergency surgeries (26%) (Hauser et al., Journal of Cardiovascular Electrophysiology, 2022). A 55-study meta-analysis of 286,349 patients found leadless tamponade risk 2.36 times that of transvenous leads, 0.84% versus 0.46%. Half of MAUDE perforations had no identifiable device or operator problem, meaning the operator simply could not feel where the tip was relative to the wall.
Current guidance is tactile feedback and fluoroscopy. TCP at the fixation site reads myocardium versus pericardial fluid or fat before deployment, giving the last warning before the tines or helix go too far.
Intravascular Plaque Characterization
Inside the vessel, TCP distinguishes calcified plaque from thrombus by impedance signature. Calcium reads differently than soft thrombus, which reads differently from lipid-rich plaque. That distinction changes the intervention: atherectomy for calcified plaque, anticoagulation or aspiration for thrombus.
An impedance-based guidewire patent filed in 2025 describes bipolar through tetrapolar electrode configurations on a standard guidewire for exactly this: real-time tissue characterization during navigation without added hardware. TCP at the catheter tip makes that reading quantitative and continuous rather than a single snapshot.