A new method for multi-site cardiac pacing using leadless electrodes and high frequency transthoracic currents

Area of Science:

• Biomedical Engineering
• Cardiovascular Research
• Medical Devices

Background:

• Traditional cardiac pacing with long leads faces complications like adhesions, fractures, and infections.
• Existing leadless pacemakers are often battery-operated and relatively large.

Purpose of the Study:

• To present the initial design and animal experimental results of a new ultrathin leadless cardiac pacing device.
• To evaluate the feasibility of a novel high-frequency alternating electrical field (HFAF) activated pacing system.

Main Methods:

• Developed a 40 × 0.5 mm myocardial rectifying device implanted in the right ventricle and epicardial veins.
• Tested the device in a swine model under open and closed chest conditions using endocardial and cardiac venous approaches.
• Activated the device via subcutaneous application of short trains of 250 kHz HFAF.

Main Results:

• Successfully demonstrated cardiac pacing in swine under various conditions (endocardial, venous, open/closed chest).
• Measured pacing thresholds including current, voltage, and pulse duration.
• Confirmed the device converts HFAF transients to unidirectional current pulses for myocardial stimulation.

Conclusions:

• The ultrathin leadless device shows promise for effective cardiac pacing.
• This HFAF-activated system allows for multi-point leadless stimulation, potentially overcoming limitations of current pacing leads.
• The technology has potential applications in various pacing needs, including Cardiac Resynchronization Therapy (CRT).