HIGH-STAKES SURGICAL ABLATION
Background
Atrial fibrillation is the most common cardiac arrhythmia, affecting millions of patients and significantly increasing the risk of stroke. For patients already undergoing open-heart surgery for other reasons, such as valve repair or coronary bypass, surgeons can ablate the cardiac tissue causing the arrhythmia as a concomitant procedure during the same operation.
The Epicor Cardiac Ablation System by St. Jude Medical used high-intensity focused ultrasound to create lesions around the four pulmonary veins, disrupting the electrical signals that cause atrial fibrillation. The system delivered a circumferential "box lesion" through epicardial application, outside the heart and without entering the chambers, in approximately ten minutes.
Areteworks was brought in to design the user experience across the full Epicor system: the Ablation Control System console, the workflow guidance for the multi-step procedure, and the integration between the disposable ablation devices and the on-screen interface.
DESIGNING UX FOR THE CARDIAC SURGICAL SUITE
Challenge
The cardiac surgical suite is one of the highest-stakes environments in medicine. The patient is on cardiopulmonary bypass. The surgical team operates against the clock. The ablation procedure happens alongside the primary surgery, and the interface must guide the team without interrupting the surgical flow.
Multiple users interact with the system in coordinated handoffs. The cardiac surgeon directs the procedure but operates in the sterile field with gloved hands and surgical loupes. The circulating nurse or perfusionist operates the console. The team communicates verbally while the device delivers ablation across three depth phases over ten minutes.
The hardware itself added complexity. The UltraCinch ablation device came in seven sizes and required correct sizing for effective lesions. The Positioning and Sizing system guided that selection. The optional UltraWand extended ablation to additional anatomical regions. The full workflow had to integrate hardware sizing, disposable selection, automated ablation cycles, and real-time progress feedback into one coherent surgical procedure.
TRANSLATING SURGICAL WORKFLOW INTO INTUITIVE UX
Solution
Areteworks led the user experience design across the Ablation Control System and the surgical workflow. The work began with observation in cardiac surgical suites and conversations with cardiac surgeons, perfusionists, and operating room nurses about how the procedure actually unfolded in practice.
We mapped the full workflow from patient prep through device sizing, UltraCinch placement, ablation cycles, optional UltraWand use, and post-procedure documentation. Each step was designed to support the verbal communication patterns that cardiac surgical teams already use, surfacing the right information for the right team member at the right moment.
The console interface used clear visual hierarchy to communicate ablation progress across the three depth phases, so the surgical team could anticipate completion without watching the screen continuously. Alarms and feedback were designed to be unmistakable but not disruptive to the broader surgical environment.
The final design supported open-chest surgical ablation as a concomitant procedure during cardiac surgeries. The Epicor system received FDA clearance and CE Mark for surgical ablation of cardiac tissue.