Electrical and Computer Engineering Department, University of California Los Angeles, 420 Westwood Plaza, Los Angeles, CA, 90095, USA.
Texas Heart Institute, 6770 Bertner Avenue, Houston, TX, 77030, USA.
Sci Rep. 2020 Feb 7;10(1):2067. doi: 10.1038/s41598-020-59017-z.
About 30% of patients with impaired cardiac function have ventricular dyssynchrony and seek cardiac resynchronization therapy (CRT). In this study, we demonstrate synchronized biventricular (BiV) pacing in a leadless fashion by implementing miniaturized and wirelessly powered pacemakers. With their flexible form factors, two pacemakers were implanted epicardially on the right and left ventricles of a porcine model and were inductively powered at 13.56 MHz and 40.68 MHz industrial, scientific, and medical (ISM) bands, respectively. The power consumption of these pacemakers is reduced to µW-level by a novel integrated circuit design, which considerably extends the maximum operating distance. Leadless BiV pacing is demonstrated for the first time in both open-chest and closed-chest porcine settings. The clinical outcomes associated with different interventricular delays are verified through electrophysiologic and hemodynamic responses. The closed-chest pacing only requires the external source power of 0.3 W and 0.8 W at 13.56 MHz and 40.68 MHz, respectively, which leads to specific absorption rates (SARs) 2-3 orders of magnitude lower than the safety regulation limit. This work serves as a basis for future wirelessly powered leadless pacemakers that address various cardiac resynchronization challenges.
约 30%心功能受损的患者存在心室不同步，并寻求心脏再同步治疗（CRT）。在这项研究中，我们通过实现微型化和无线供电起搏器，以无导线方式演示了双心室（BiV）同步起搏。两个起搏器采用灵活的外形尺寸，分别在心外膜上植入猪模型的左右心室，并分别在 13.56 MHz 和 40.68 MHz 工业、科学和医疗（ISM）频段进行感应供电。通过新颖的集成电路设计，将这些起搏器的功耗降低到微瓦级，从而大大延长了最大工作距离。首次在开胸和闭胸猪模型中演示了无导线 BiV 起搏。通过电生理和血液动力学反应验证了不同室间延迟相关的临床结果。闭胸起搏仅在 13.56 MHz 和 40.68 MHz 时分别需要 0.3 W 和 0.8 W 的外部源功率，这导致比安全规定限制低 2-3 个数量级的特定吸收率（SAR）。这项工作为未来的无线供电无导线起搏器奠定了基础，这些起搏器可以解决各种心脏再同步挑战。
