Injectable Hydrogel Electrodes to Prevent Ventricular Arrhythmias

可注射水凝胶电极预防室性心律失常 在美国，心脏性猝死每年造成35万人死亡，主要原因是 致死性室性心律失常潜在的电生理紊乱机制上负责 室性心律失常是瘢痕或其他病变心肌中的传导速度延迟。获得 跨越心脏瘢痕区的较小血管和分支可提供改善的起搏; 然而，没有足够小的起搏导线来引导这些较小的支流。本研究 提出一种治疗和管理室性心律失常的新方法--开发一种新的导电材料 它可以填充大小冠状血管，并将这些支流转化为柔性电极， 在疤痕区域中捕获。我们的合作团队结合了临床专业知识（Razavi）和 生物材料科学（Cosgriff-Hernandez）已经证明了用原位起搏器起搏心肌的早期可行性。 在猪模型中固化水凝胶。我们计划在这个初步概念验证的基础上开发一种组合材料 和输送系统，可以与现有的起搏器技术接口，以大大扩展其能力， 治疗室性心律失常。在成功完成这些目标后，我们将利用一组体外 以及体内试验以确定这种新的可注射水凝胶电极的安全性和有效性。确认 与标准护理单点起搏相比，增加的激活面积将验证这种方法的有效性。 消除导致致死性心室肌损伤的瘢痕心肌传导延迟的创新方法 心律不齐我们将使用心肌梗死后模型来证明水凝胶电极起搏降低了 室性心律失常和除颤电击的频率。无痛刺激心脏的广泛区域 使用来自这些水凝胶电极的平面波阵面传播提供了一种新的心脏成像 这将改变心律管理的前景。

Injectable Hydrogel Electrodes to Prevent Ventricular Arrhythmias In the United States, sudden cardiac death accounts for 350,000 deaths per year with the leading cause being lethal ventricular arrhythmias. The underlying electrophysiologic derangement mechanistically responsible for ventricular arrhythmias is delayed conduction velocity in scarred or otherwise diseased myocardium. Access to the smaller vessels and tributaries that cross over scarred region of the heart could provide improved pacing; however, there are no pacing leads small enough to navigate these smaller tributaries. In this research, we propose a novel method to treat and manage ventriculararrhythmias – developmentof a newconductive material that can fill both large and small coronary vessels and convert these tributaries into flexible electrodes to restore capture across regions of scarring. Our collaborative team that combines clinical expertise (Razavi) and biomaterial science (Cosgriff-Hernandez) has demonstrated early feasibility of pacing myocardium with an in situ curing hydrogel in a pig model. We plan to build on this initial proof of concept to develop a combined material and delivery system that can interface with existing pacemaker technology to greatly expand their capability to treat ventricular arrhythmias. Upon successful completion of these aims, we will have utilized a battery of in vitro and in vivo tests to establish the safety and efficacy of this new injectable hydrogel electrode. Confirmation of increased activation area as compared to standard-of-care single point pacing will validate the efficacy of this innovative approach to eliminate the conduction delay in scarred myocardium that results in lethal ventricular arrhythmias. We will use a post-myocardial infarct model to demonstrate that hydrogel electrode pacing reduces the frequency of ventricular arrhythmias and defibrillation shocks. Painless stimulation of wide areas of the heart using planar wavefront propagation from these hydrogel electrodes provides a new cardiac resynchronization therapy that will alter the landscape of cardiac rhythm management.