Novel lead for selective His bundle sensing and low-threshold pacing
用于选择性希束传感和低阈值起搏的新型导线
基本信息
- 批准号:10421275
- 负责人:
- 金额:$ 22.88万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2021
- 资助国家:美国
- 起止时间:2021-06-07 至 2024-05-31
- 项目状态:已结题
- 来源:
- 关键词:3D PrintAddressAdoptionApicalCanis familiarisCardiomyopathiesCathetersChronicClinicalCongestive Heart FailureDetectionDevelopmentDevicesElectrodesFunctional disorderGoalsHeartHeart RateHeart failureImplantIncidenceLeadLengthLifeLocationLongevityModelingMonitorMyocardialMyocardiumNodalPacemakersPatient-Focused OutcomesPatientsPerformancePhasePhysiciansPhysiologic pulsePhysiologicalProceduresResolutionRight ventricular structureRiskSystemTachycardiaTechniquesTechnologyTestingTrainingUtahValidationVentricularVentricular TachycardiaVentricular septumbasecanine modelcardiogenesisclinically relevantcohortdesignexperiencehemodynamicsimplantable deviceimplantationimprovedin vivoindividual patientindividual responsemortalitynovelprototypesample fixationtooltrend
项目摘要
Project Summary
Nodal dysfunction in patients often requires the implantation of a pacemaker to maintain physiologically
normal heart rates. Historically, a pacemaker in the right ventricular apex has delivered pacing pulses to the
ventricles. In some patients, chronic pacing in the right ventricle may lead to ventricular dyssynchrony, pacing
induced cardiomyopathy, and increased congestive heart failure incidence. Biventricular pacing has been
shown to lead to improved performance compared to right ventricular pacing, but up to 1/3 of patients are non-
responders to biventricular pacing. Permanent His bundle pacing has recently been shown to lead to less heart
failure and improved synchronicity, with a trend towards a mortality benefit as compared to the standard right
ventricular or biventricular lead placement.
Limitations that have slowed the adoption of His bundle pacing include 1) higher pacing thresholds as
compared to other lead configurations, which may reduce battery life in implanted devices for patients with high
pacing demand, and 2) a lack of selectivity in sensing and pacing the His bundle and adjacent ventricular
myocardium. Therapies such as anti-tachycardia pacing that utilize sensing may be less effective if the His
activation and the local myocardial activations lead to inappropriate calculation of the ventricular tachycardia
cycle length.
A novel, transvenous, multielectrode pacing lead is proposed that will allow for low threshold, selective
sensing and pacing of the His bundle and the adjacent ventricular myocardium. Refinement of the lead
configuration will be performed in ex vivo canine hearts, and validation of the new lead will be demonstrated in
an in vivo, chronic dog model. The lead configuration will be deployable with currently available tools and
techniques and will allow the physician to optimize the pacing therapy based on the response of individual
patients.
Completion of this project will lead to a substantially improved lead system for His bundle pacing
applications. This translational project may have an immediate impact on pacemaker implantation for many of
the one million patients worldwide that are implanted with pacemakers each year.
项目摘要
患者的结节功能障碍通常需要植入起搏器以维持生理功能
心率正常。历史上,右室心尖部的起搏器将起搏脉冲发送到
脑室。在一些患者中,右室的慢性起搏可能会导致心室不同步,
诱发心肌病,增加充血性心力衰竭的发生率。双室起搏已经被
与右室起搏相比,显示出改善的效果,但多达三分之一的患者没有
双室起搏的应答者。最近有研究表明,永久性希氏束起搏可导致心脏收缩
失败和改善的同步性,与标准权利相比,有提高死亡率的趋势
脑室或双室导联置入。
阻碍采用HIS束起搏的限制包括:1)较高的起搏阈值
与其他导线配置相比,其他导线配置可能会缩短高电压患者植入设备的电池寿命
起搏需求,以及2)在感知和起搏希氏束和相邻心室时缺乏选择性
心肌。抗心动过速起搏等利用感知的疗法可能不太有效,如果
激活和局部心肌激活导致对室性心动过速的错误计算
周期长度。
提出了一种新的经静脉多电极起搏导线,它将允许低阈值、选择性地起搏
感知和起搏希氏束和邻近的心肌。提炼销售线索
配置将在体外犬心脏中进行,新导线的验证将在
一种活体、慢性的狗模型。销售线索配置将可使用当前可用的工具和
技术,并将允许医生根据个体的反应来优化起搏治疗
病人。
该项目的完成将大大改善HIS束起搏的导联系统
申请。这一翻译项目可能会对许多患者的起搏器植入产生直接影响
全球每年有100万名患者植入心脏起搏器。
项目成果
期刊论文数量(3)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Shorter distance between the esophagus and the left atrium is associated with higher rates of esophageal thermal injury after radiofrequency ablation.
- DOI:10.1111/jce.15554
- 发表时间:2022-07
- 期刊:
- 影响因子:2.7
- 作者:Ishidoya, Yuki;Kwan, Eugene;Dosdall, Derek J.;Macleod, Rob S.;Navaravong, Leenhapong;Steinberg, Benjamin A.;Bunch, T. Jared;Ranjan, Ravi
- 通讯作者:Ranjan, Ravi
Atrial slow conduction develops and dynamically expands during premature stimulation in an animal model of persistent atrial fibrillation.
- DOI:10.1371/journal.pone.0258285
- 发表时间:2021
- 期刊:
- 影响因子:3.7
- 作者:Lange M;Hirahara AM;Ranjan R;Stoddard GJ;Dosdall DJ
- 通讯作者:Dosdall DJ
Short-term natural course of esophageal thermal injury after ablation for atrial fibrillation.
- DOI:10.1111/jce.15553
- 发表时间:2022-07
- 期刊:
- 影响因子:2.7
- 作者:Ishidoya, Yuki;Kwan, Eugene;Dosdall, Derek J.;Macleod, Rob S.;Navaravong, Leenhapong;Steinberg, Benjamin A.;Bunch, T. Jared;Ranjan, Ravi
- 通讯作者:Ranjan, Ravi
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Derek J Dosdall其他文献
Cardiac ECV is more robust than post-contrast cardiac T<sub>1</sub> for evaluating temporal changes in LV fibrosis
- DOI:
10.1186/1532-429x-16-s1-p25 - 发表时间:
2014-01-16 - 期刊:
- 影响因子:
- 作者:
Kyungpyo Hong;Matthias Koopmann;Eugene G Kholmovski;Eric C Huang;Nan Hu;Richard Levenson;Sathya Vijayakumar;Derek J Dosdall;Ravi Ranjan;Daniel Kim - 通讯作者:
Daniel Kim
Inter-subject variation in partition coefficient is largely due to variation in LGE blood T1
- DOI:
10.1186/1532-429x-15-s1-p48 - 发表时间:
2013-01-30 - 期刊:
- 影响因子:
- 作者:
Kyung P Hong;Eugene Kholmovski;Sathya Vijayakumar;Derek J Dosdall;Christopher McGann;Ravi Ranjan;Nassir F Marrouche;Daniel Kim - 通讯作者:
Daniel Kim
Derek J Dosdall的其他文献
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{{ truncateString('Derek J Dosdall', 18)}}的其他基金
A New Approach for Measurement of Electrical Conductivities of Cardiac Tissues
测量心脏组织电导率的新方法
- 批准号:
10162414 - 财政年份:2020
- 资助金额:
$ 22.88万 - 项目类别:
Antitachycardia pacing and improved lead for ventricular conduction system stimulation
抗心动过速起搏和改善心室传导系统刺激的导联
- 批准号:
10478220 - 财政年份:2015
- 资助金额:
$ 22.88万 - 项目类别:
His-Purkinje Pacing for Low Energy Implantable Cardioverter Defibrillators
用于低能量植入式心脏复律除颤器的希氏浦肯野起搏
- 批准号:
8944632 - 财政年份:2015
- 资助金额:
$ 22.88万 - 项目类别:
Antitachycardia pacing and improved lead for ventricular conduction system stimulation
抗心动过速起搏和改善心室传导系统刺激的导联
- 批准号:
10677873 - 财政年份:2015
- 资助金额:
$ 22.88万 - 项目类别:
Antitachycardia pacing and improved lead for ventricular conduction system stimulation
抗心动过速起搏和改善心室传导系统刺激的导联
- 批准号:
10298724 - 财政年份:2015
- 资助金额:
$ 22.88万 - 项目类别:
Role of the Purkinje System in Long Duration Ventricular Fibrillation
浦肯野系统在长时心室颤动中的作用
- 批准号:
8437167 - 财政年份:2010
- 资助金额:
$ 22.88万 - 项目类别:
Role of the Purkinje System in Long Duration Ventricular Fibrillation
浦肯野系统在长时心室颤动中的作用
- 批准号:
8119222 - 财政年份:2010
- 资助金额:
$ 22.88万 - 项目类别:
Role of the Purkinje System in Long Duration Ventricular Fibrillation
浦肯野系统在长时心室颤动中的作用
- 批准号:
8135290 - 财政年份:2010
- 资助金额:
$ 22.88万 - 项目类别:
Role of the Purkinje System in Long Duration Ventricular Fibrillation
浦肯野系统在长时心室颤动中的作用
- 批准号:
7662604 - 财政年份:2009
- 资助金额:
$ 22.88万 - 项目类别:
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