Leadless cardiac resynchronization therapy - an in-vivo proof-of-concept study of wireless pacemaker synchronization.
Publisher DOI
PubMed ID
30639936
Abstract
BACKGROUND
Contemporary leadless pacemakers (PMs) only feature single-chamber ventricular pacing. However, the majority of patients requires dual-chamber pacing or cardiac resynchronization therapy (CRT). Several leadless PMs implanted in the same heart would make that possible if they are able to synchronize their activity in an efficient, safe and reliable way. Thus, a dedicated ultra-low-power wireless communication method for pacemaker synchronization is required.
OBJECTIVE
The purpose of this study was to develop a leadless CRT system and to evaluate its function in vivo.
METHODS
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.
RESULTS
We successfully performed CRT pacing with three independent devices synchronizing their action using CIC. No arrhythmias were induced by the novel communication technique. 98% 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 beats per minute.
CONCLUSION
Leadless pacemakers are able to synchronize their action using CIC and may overcome the key limitation of contemporary leadless pacemakers.
Contemporary leadless pacemakers (PMs) only feature single-chamber ventricular pacing. However, the majority of patients requires dual-chamber pacing or cardiac resynchronization therapy (CRT). Several leadless PMs implanted in the same heart would make that possible if they are able to synchronize their activity in an efficient, safe and reliable way. Thus, a dedicated ultra-low-power wireless communication method for pacemaker synchronization is required.
OBJECTIVE
The purpose of this study was to develop a leadless CRT system and to evaluate its function in vivo.
METHODS
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.
RESULTS
We successfully performed CRT pacing with three independent devices synchronizing their action using CIC. No arrhythmias were induced by the novel communication technique. 98% 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 beats per minute.
CONCLUSION
Leadless pacemakers are able to synchronize their action using CIC and may overcome the key limitation of contemporary leadless pacemakers.
Date Issued
2019-06
Publication Type
Article
Subject(s)
Subjects
intra-body communication intracardiac communication leadless cardiac resynchronization therapy leadless pacemaker leadless pacing pacemaker
Language(s)
en
Author(s)
Bereuter, Lukas | |
Niederhauser, Thomas | |
Kucera, Martin | |
Loosli, Dominic | |
Steib, Immanuel | |
Schildknecht, Marcel | |
Zurbuchen, Adrian | |
Noti, Fabian | |
Tanner, Hildegard | |
Haeberlin, Andreas |
Additional Credits
Journal
Heart rhythm
Publisher
Elsevier
ISSN
1547-5271
Access(Rights)
restricted