Materials Perspectives for Self-Powered Cardiac Implantable Electronic Devices toward Clinical Translation.
Materials Perspectives for Self-Powered Cardiac Implantable Electronic Devices toward Clinical Translation.
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自供电心脏植入式电子装置的材料展望及临床应用。
DOI：
10.1021/accountsmr.1c00078
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发表时间：
2021-09-24
影响因子：
14.6
通讯作者：
Wang X
中科院分区：
文献类型：
--
作者：
Li J;Wang X
以心脏起搏器为代表的植入式电子设备（CIED）在现代社会中发挥着至关重要的救生作用。虽然目前的CIED在性能、安全性和小型化方面发展迅速，但笨重和刚性的电池对进一步开发可附接并符合组织而不引起不期望的生理变化的软系统造成了最大的障碍。超过50%的起搏器患者需要额外的手术来更换耗尽的电池。电池突然故障和失效占植入无导线起搏器的2.4%。电池也有致命干扰诊断磁共振成像（MRI）的风险。将植入式纳米发电机（i-NG）技术应用于CIEDs被认为是解决电池挑战的一种有前途的解决方案，并实现了自供电能力。基于摩擦电（TENG）或压电（PENG）原理的I-NG可以有效地将生物力学能量转化为电能。同时，一个完整的心跳周期提供约0.7 J的生物力学能量或0.93 W的平均功率，考虑到起搏器的功耗为5-10 μW，心脏除颤器的功耗为10-100 μW，这足以用于CIED的操作。因此，利用有效的、柔软的、柔性的、轻质的和生物相容的i-NG来消除CIEDs中的笨重电池组件并实现自我可持续的操作是实际的。在这个快速发展的跨学科领域，材料创新是技术发展的基石。在这里，我们带来了一些关于材料设计和工程的关键观点，这些观点对于将NG驱动的CIED推向临床应用至关重要。本账户首先简要介绍心脏电生理学，以及其与最先进的心脏NG技术接口的简短历史。详细讨论了NG供电CIED的三个关键组件，包括NG设备本身、包装材料和刺激电极。心脏NG是将心跳能量转化为电能的重要组成部分。它需要具有长期动态稳定性的高性能机电耦合材料。包装材料对于确保器械在跳动的心脏上长期稳定运行至关重要。鉴于其独特的手术环境，在其开发过程中需要考虑一些标准，包括灵活性、生物相容性、生物相容性、血液相容性和生物粘附性。刺激电极是与心脏组织电连接的唯一材料。它们应该提供电容性电荷注入，并模仿柔软和潮湿的内在组织，以稳定的生物界面。在材料和器械快速发展的推动下，我们设想基于NG的CIED的发展将迅速从心外膜到心内，从单功能到多功能，并采用微创植入手术。这一发展趋势将为新兴材料科学和工程提供许多研究机会，最终将使NG技术成为为未来CIED提供动力的主流战略。
Represented by pacemakers, implantable electronic devices (CIEDs) are playing a vital life-saving role in modern society. Although the current CIEDs are evolving quickly in terms of performance, safety, and miniaturization, the bulky and rigid battery creates the largest hurdle toward further development of a soft system that can be attached and conform to tissues without causing undesirable physiologic changes. Over 50% of patients with pacemakers require additional surgery procedures to replace a drained battery. Abrupt battery malfunction and failure contributes up to 2.4% of implanted leadless pacemakers. The battery also has risks of lethal interference with diagnostic magnetic resonance imaging (MRI). Applying the implantable nanogenerators (i-NGs) technology to CIEDs is regarded as a promising solution to the battery challenge and enables self-powering capability. I-NGs based on the principle of either triboelectricity (TENG) or piezoelectricity (PENG) can convert biomechanical energy into electricity effectively. Meanwhile, a complete heartbeat cycle provides a biomechanical energy of ~0.7 J or an average power of 0.93 W, which is sufficient for the operation of CIEDs considering the power consumption of 5–10 μW for a pacemaker and 10–100 μW for a cardiac defibrillator. It is therefore practical to leverage the effective, soft, flexible, lightweight, and biocompatible i-NGs to eliminate the bulky battery component in CIEDs and achieve self-sustainable operation. In this rapidly evolving interdisciplinary field, materials innovation acts as a cornerstone that frames the technology development. Here we bring a few critical perspectives regarding materials design and engineering, which are essential in leading the NG-powered CIEDs toward clinical translations. This Account starts with a brief introduction of the cardiac electrophysiology, as well as its short history to interface the state-of-the-art cardiac NG technologies. Three key components of NG-powered CIEDs are discussed in detail, including the NG device itself, the packaging material, and the stimulation electrodes. Cardiac NG is the essential component that converts heartbeat energy into electricity. It demands high-performance electromechanical coupling materials with long-term dynamic stability. The packaging material is critical to ensure a long-term stable operation of the device on a beating heart. Given the unique operation environment, a few criteria need to be considered in its development, including flexibility, biocompatibility, antifouling, hemocompatibility, and bioadhesion. The stimulation electrodes are the only material interfacing the heart tissue electrically. They should provide capacitive charge injection and mimic the soft and wet intrinsic tissues for the sake of stable biointerfaces. Driven by the rapid materials and device advancement, we envision that the evolution of NG-based CIEDs will quickly move from epicardiac to intracardiac, from single-function to multifunction, and with a minimal-invasive implantation procedure. This trend of development will open many research opportunities in emerging materials science and engineering, which will eventually lead the NG technology to a prevailing strategy for powering future CIEDs.
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影响因子：
17.6
作者：
Li J;Kang L;Yu Y;Long Y;Jeffery JJ;Cai W;Wang X
通讯作者：
Wang X
影响因子：
6.1
作者：
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通讯作者：
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影响因子：
29.4
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Zhang, Haixia
影响因子：
29.4
作者：
Hwang, Geon-Tae;Park, Hyewon;Lee, Keon Jae
通讯作者：
Lee, Keon Jae