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Non-fluoroscopic Catheter Tracking for Fluoroscopy Reduction in Interventional Electrophysiology

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Towards Low Energy Atrial Defibrillation.

Philip Walsh¹, Vivek Kodoth², David McEneaney³

¹Centre for Advanced Cardiovascular Research, Ulster University, BT37 0QB, UK. Walsh-P3@email.ulster.ac.uk.

Sensors (Basel, Switzerland)

|September 26, 2015

Summary

This study introduces a wireless implantable atrial defibrillator that uses radio frequency power. It successfully measured intracardiac impedance and delivered low-energy cardioversion shocks, showing promise for atrial fibrillation treatment.

Keywords:

RF battery-free defibrillator impedance implantable wireless

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Area of Science:

Biomedical Engineering
Cardiovascular Devices
Implantable Electronics

Background:

Atrial fibrillation (AF) necessitates effective defibrillation strategies.
Current defibrillators often require invasive power sources or less efficient energy transfer.
Intracardiac impedance (ICI) monitoring may offer insights into defibrillation efficacy.

Purpose of the Study:

To report a novel wireless-powered implantable atrial defibrillator system.
To enable measurement of intracardiac impedance (ICI) during defibrillation.
To evaluate the efficacy of radio frequency (RF) generated shocks for cardioversion in AF patients.

Main Methods:

Developed a system with an external RF power transmitter and a passive implantable receiver.
Implemented dual modes: low-power sensing for ICI measurement and high-power for synchronized shock delivery.
Tested RF power transfer efficiency (>47% DC-to-DC) and shock delivery (>180 W).
Conducted a randomized trial in 30 AF patients using RF-generated monophasic or biphasic shocks.

Main Results:

Achieved efficient transcutaneous power transfer (>5 W in sense mode, >180 W in shock mode).
Mean energy for successful cardioversion was 8.51 J ± 3.16 J.
Successful cardioversion correlated with a significant decrease in ICI and a significant variation in impedance-amplitude-spectrum-area (IAMSA).

Conclusions:

Wireless RF power transfer is feasible for implantable atrial defibrillators.
ICI measurement during cardioversion provides a potential biomarker for treatment success.
This technology advances low-energy atrial defibrillation, improving AF management.