Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; ARTORG Center for Biomedical Engineering, University of Bern, Bern, Switzerland.
Institute for Human Centered Engineering, Bern University of Applied Sciences, Bern, Switzerland.
Heart Rhythm. 2019 Jun;16(6):936-942. doi: 10.1016/j.hrthm.2019.01.010. Epub 2019 Jan 11.
Contemporary leadless pacemakers (PMs) only feature single-chamber ventricular pacing. However, the majority of patients require dual-chamber pacing or cardiac resynchronization therapy (CRT). Several leadless PMs implanted in the same heart would make that possible if they were able to synchronize their activity in an efficient, safe, and reliable way. Thus, a dedicated ultra-low-power wireless communication method for PM synchronization is required.
The purpose of this study was to develop a leadless CRT system and to evaluate its function in vivo.
Device synchronization was implemented using conductive intracardiac communication (CIC). Communication frequencies were optimized for intracardiac device-device communication. Energy consumption, safety, and reliability of the leadless PM system were tested in animal experiments.
We successfully performed CRT pacing with 3 independent devices synchronizing their action using CIC. No arrhythmias were induced by the novel communication technique. Ninety-eight percent of all communication impulses were transmitted successfully. The optimal communication frequency was around 1 MHz, with a corresponding transmitted power of only 0.3 μW at a heart rate of 60 bpm.
Leadless PMs are able to synchronize their action using CIC and may overcome the key limitation of contemporary leadless PMs.
当代无导线起搏器（PM）仅具备单腔心室起搏功能。然而，大多数患者需要双腔起搏或心脏再同步治疗（CRT）。如果多个无导线 PM 能够以有效、安全和可靠的方式同步其活动，那么在同一心脏中植入多个无导线 PM 就成为可能。因此，需要一种专用的超低功率无线通信方法来实现 PM 同步。
本研究旨在开发一种无导线 CRT 系统，并评估其在体内的功能。
采用经皮心内通信（CIC）实现设备同步。优化了用于心内设备-设备通信的通信频率。在动物实验中测试了无导线 PM 系统的能量消耗、安全性和可靠性。
我们成功地使用 CIC 使 3 个独立的设备同步进行 CRT 起搏，新型通信技术未引发心律失常。98%的所有通信脉冲都成功传输。最佳通信频率约为 1MHz，在心率为 60bpm 时，相应的传输功率仅为 0.3μW。
无导线 PM 能够使用 CIC 来同步其活动，可能克服当代无导线 PM 的关键限制。
