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Wireless Endocardial Atrial (and Ventricular) Sensing with no Implanted Power Source: a Proposal

  • Systems-Level Quality Improvement
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Abstract

Cardiac electrical activity is mainly evaluated by monitoring the electrical biosignals. This requires a long-lasting power supply to make implantable devices cost-effective and efficient. Since the current trend is to implant catheter-free stand-alone electrodes (implantable cardiac monitors), the need for smaller devices is at odds with the need for long-life batteries. To avoid these problems, we propose a passive endocardial sensor able to monitor the movement of the considered chamber based on a permanent magnet shaped for implantation in the internal chamber of the heart (i.e. the right atrium) and an external gauss meter unit to measure sensor-induced magnetic field variations. Since the magnet is permanent, no replacement is needed after the first implant, thereby reducing the risks linked to invasive procedures, and the battery in the external device can be substituted more easily. To test our idea we used a permanent magnet mounted on the tip of a commercial catheter for heart mapping together with a dedicated gauss meter built in our laboratory. The device was tested in vitro and the magnetic field variations were acquired and measured in different conditions of movement and distances. The results demonstrate the feasibility of our approach and open an interesting new scenario where permanent magnets can be used to monitor the mechanical behaviour of the heart.

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References

  1. Priori, S. G., Blomström-Lundqvist, C., Mazzanti, A., Blom, N., Borggrefe, M., Camm, J. et al., 2015 ESC guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac deathThe task force for the Management of Patients with ventricular arrhythmias and the prevention of sudden cardiac death of the European Society of Cardiology (ESC) endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). EP Eur. 17:1601–1687, 2015. https://doi.org/10.1093/europace/euv319.

    Article  Google Scholar 

  2. Boriani, G., Nesti, M., Ziacchi, M., and Padeletti, L., Cardiac resynchronization therapy: an overview on guidelines. Heart Fail. Clin. 13:117–137, 2017. https://doi.org/10.1016/j.hfc.2016.07.010.

    Article  PubMed  Google Scholar 

  3. Boriani, G., Cimaglia, P., Biffi, M., Martignani, C., Ziacchi, M., Valzania, C. et al., Cost-effectiveness of implantable cardioverter-defibrillator in today’s world. Indian Heart J. 66(Suppl 1):S101–S104, 2014. https://doi.org/10.1016/j.ihj.2013.12.034.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Diemberger, I., Mazzotti, A., Giulia, M. B., Biffi, M., Cristian, M., Massaro, G. et al., From lead management to implanted patient management: Systematic review and meta-analysis of the last 15 years of experience in lead extraction. Expert Rev. Med. Devices 10:551–573, 2013. https://doi.org/10.1586/17434440.2013.811837.

    Article  CAS  PubMed  Google Scholar 

  5. De Maria, E., Diemberger, I., Vassallo, P. L., Pastore, M., Giannotti, F., Ronconi, C. et al., Prevention of infections in cardiovascular implantable electronic devices beyond the antibiotic agent. J. Cardiovasc. Med. Hagerstown Md 15:554–564, 2014. https://doi.org/10.2459/JCM.0000000000000008.

    Article  CAS  Google Scholar 

  6. Montgomery, J. A., and Ellis, C. R., Longevity of cardiovascular implantable electronic devices. Card Electrophysiol. Clin. 10:1–9, 2018. https://doi.org/10.1016/j.ccep.2017.11.001.

    Article  PubMed  Google Scholar 

  7. Domenichini, G., Gonna, H., Sharma, R., Conti, S., Fiorista, L., Jones, S. et al., Non-laser percutaneous extraction of pacemaker and defibrillation leads: A decade of progress. Eur. Eur. Pacing Arrhythm Card Electrophysiol. J. Work Groups Card Pacing Arrhythm Card Cell. Electrophysiol. Eur. Soc. Cardiol. 19:1521–1526, 2017. https://doi.org/10.1093/europace/euw162.

    Article  Google Scholar 

  8. Kancharla, K., Acker, N. G., Li, Z., Samineni, S., Cai, C., Espinosa, R. E. et al., Efficacy and safety of Transvenous Lead extraction in the device laboratory and operating room guided by a novel risk stratification scheme. JACC Clin. Electrophysiol. 5:174–182, 2019. https://doi.org/10.1016/j.jacep.2019.01.001.

    Article  PubMed  Google Scholar 

  9. Ciconte, G., Giacopelli, D., and Pappone, C., The role of implantable cardiac monitors in atrial fibrillation management. J. Atr. Fibrillation 10, 2017. https://doi.org/10.4022/jafib.1590.

  10. Diemberger, I., Gardini, B., Martignani, C., Ziacchi, M., Corzani, A., Biffi, M. et al., Holter ECG for pacemaker/defibrillator carriers: What is its role in the era of remote monitoring? Heart. Br Card Soc. 101:1272–1278, 2015. https://doi.org/10.1136/heartjnl-2015-307614.

    Article  CAS  Google Scholar 

  11. Corzani, A., Ziacchi, M., Biffi, M., Allaria, L., Diemberger, I., Martignani, C. et al., Clinical management of electromagnetic interferences in patients with pacemakers and implantable cardioverter-defibrillators: Review of the literature and focus on magnetic resonance conditional devices. J Cardiovasc. Med. Hagerstown Md 16:704–713, 2015. https://doi.org/10.2459/JCM.0000000000000301.

    Article  Google Scholar 

  12. Mulder, B. A., van Gelder, I. C., and Rienstra, M., Device-detected atrial fibrillation: Evidencing the knowledge gap. Circulation, 2019. https://doi.org/10.1161/CIRCULATIONAHA.119.040549.

    Article  Google Scholar 

  13. Solari, D., Bertero, E., Miceli, R., Brunelli, C., Ameri, P., and Canepa, M., Methods, accuracy and clinical implications of atrial fibrillation detection by cardiac implantable electronic devices. Int. J. Cardiol. 236:262–269, 2017. https://doi.org/10.1016/j.ijcard.2016.12.189.

    Article  PubMed  Google Scholar 

  14. Leischik, R., Littwitz, H., Dworrak, B., Garg, P., Zhu, M., and Sahn, D.J., et al., Echocardiographic evaluation of left atrial mechanics: Function, history, novel techniques, advantages, and pitfalls. BioMed Res Int 2015. https://www.hindawi.com/journals/bmri/2015/765921/ (accessed March 14, 2018).

  15. Zannoli, R., Corazza, I., Cremonesi, A., and Branzi, A., A mechanical device for aortic compliance modulation: In vitro simulation of aortic dissection treatment. J. Biomech. 40:3089–3095, 2007. https://doi.org/10.1016/j.jbiomech.2007.03.021.

    Article  PubMed  Google Scholar 

  16. Zannoli, R., Corazza, I., and Branzi, A., Mechanical simulator of the cardiovascular system. Phys. Med. 25:94–100, 2009. https://doi.org/10.1016/j.ejmp.2008.02.007.

    Article  PubMed  Google Scholar 

  17. Corazza, I., Melandri, G., Nanni, S., Marcelli, E., Cercenelli, L., Bianchini, D. et al., Passive COUNTERPULSATION: Biomechanical rationale and clinical validation. J. Mech. Med. Biol. 13:UNSP 1340004, 2013. https://doi.org/10.1142/S0219519413400046.

    Article  Google Scholar 

  18. Corazza, I., Casadei, L., Bonafè, E., Cercenelli, L., Marcelli, E., and Zannoli, R., How to transform a fixed stroke alternating syringe ventricle into an adjustable elastance ventricle. Rev. Sci. Instrum. 89, 2018. https://doi.org/10.1063/1.5030100.

    Article  Google Scholar 

  19. Tyers, G. F., Mills, P., Clark, J., Cheesman, M., Yeung-Lai-Wah, J. A., and Brownlee, R. R., Bipolar leads for use with permanently implantable cardiac pacing systems: A review of limitations of traditional and coaxial configurations and the development and testing of new conductor, insulation, and electrode designs. J. Investig. Surg. Off. J. Acad. Surg. Res. 10:1–15, 1997.

    CAS  Google Scholar 

  20. Mahida, S., Sacher, F., Dubois, R., Sermesant, M., Bogun, F., Haïssaguerre, M. et al., Cardiac imaging in patients with ventricular tachycardia. Circulation 136:2491–2507, 2017. https://doi.org/10.1161/CIRCULATIONAHA.117.029349.

    Article  PubMed  Google Scholar 

  21. Sy, R. W., Thiagalingam, A., and Stiles, M. K., Modern electrophysiology mapping techniques. Heart Lung Circ. 21:364–375, 2012. https://doi.org/10.1016/j.hlc.2012.04.007.

    Article  PubMed  Google Scholar 

  22. Borlich, M., Iden, L., Kuhnhardt, K., Paetsch, I., Hindricks, G., and Sommer, P., 3D mapping for PVI- geometry, image integration and incorporation of contact force into work flow. J. Atr. Fibrillation 10:1795, 2018. https://doi.org/10.4022/jafib.1795.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Martin, R., Hocini, M., Haïsaguerre, M., Jaïs, P., and Sacher, F., Ventricular tachycardia isthmus characteristics: Insights from high-density mapping. Arrhythmia Electrophysiol. Rev. 8:54–59, 2019. https://doi.org/10.15420/aer.2018.78.2.

    Article  Google Scholar 

  24. Misra, S., Zahid, S., Prakosa, A., Saju, N., Tandri, H., Berger, R. D. et al., Field of view of mapping catheters quantified by electrogram associations with radius of myocardial attenuation on contrast-enhanced cardiac computed tomography. Heart Rhythm 15:1617–1625, 2018. https://doi.org/10.1016/j.hrthm.2018.05.031.

    Article  PubMed  Google Scholar 

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Correspondence to Ivan Corazza.

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1) there is no conflict of interest with any financial organization regarding the material discussed in the manuscript;

2) this article does not contain any studies with human participants or animals performed by any of the authors;

3) no funds were received for this study.

Regards,

Ivan Corazza

Igor Diemberger

Pier Luca Rossi

Alessandro Lombi

Matteo Ziacchi

Christian Martignani

Romano Zannoli

Mauro Biffi

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Corazza, I., Diemberger, I., Martignani, C. et al. Wireless Endocardial Atrial (and Ventricular) Sensing with no Implanted Power Source: a Proposal. J Med Syst 43, 159 (2019). https://doi.org/10.1007/s10916-019-1277-6

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