SUBTLE Access

SUBTLE™ (sub-thoracic, total endoscopic) access allows the surgeon to access the atria through a one inch incision in the abdomen. The nContact technology allows for the creation of long linear epicardial lesions through a closed chest approach with no chest incisions, ports, lung deflation or heart dissections.  Other epicardial approaches are not closed chest; they are invasive and complex.

The table below illustrates the differences of  SUBTLE™ access over Hybrid Approaches that utilize bi-lateral thoracotomies with clamps and pens. The Hybrid approach will not be widely accepted, we believe, as cardiologists will not refer patients for such an invasive, complex procedure with significant recovery issues.

Comparison of SUBTLE™ Access to Bi-Lateral Thoracotomies

Characteristic		Bi-lateral Thoracotomies
Avoids chest incisions	Y	N
Provides direct visualization of device placement and all lesions	Y	N
Creates lesions along posterior surface of heart	Y	N
Allows patient to be in supine position, no rotation of patient during procedure	Y	N
Avoids lung deflation, especially sequential single lung ventilation	Y	N
Avoids dissections of PVs, transverse sinus and oblique sinus	Y	N
Maintains integrity of pericardium to prevent adhesions	Y	N
Complements catheter ablation, doesn’t replicate ablation lesions	Y	N
Approximate epicardial skin-skin procedure time <2 hours	Y	N
Avoids damage to intercostal nerves associated with severe acute and chronic pain	Y	N