Leadless dual-chamber pacing – a novel communication method for wireless pacemaker synchronization

Bereuter, Lukas; Gysin, Mirco; Küffer, Thomas; Kucera, Martin; Niederhauser, Thomas; Fuhrer, Jürg; Heinisch, Paul Philipp; Zurbuchen, Adrian; Obrist, Dominik; Tanner, Hildegard; Haeberlin, Andreas (2018). Leadless dual-chamber pacing – a novel communication method for wireless pacemaker synchronization. JACC. Basic to translational science, 3(6), pp. 813-823. Elsevier 10.1016/J.JACBTS.2018.07.009

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Objectives
The goal of this study was to provide a proof-of-concept for leadless dual-chamber pacing.
Background
Recently introduced leadless cardiac pacemakers effectively overcome the lead- and pocket-related limitations of conventional pacemakers. However, they only feature single-chamber pacing capability although dual-chamber pacing and synchronization between different pacing sites is highly desirable for most patients.
Methods
The presented concept involves two separate leadless pacemakers that jointly act as a leadless dual-chamber pacemaker. To preserve synchrony, these devices must communicate wirelessly with each other. Low power conductive intra-body communication was implemented as communication method, which uses blood and myocardial tissue as signal transmission medium. First, the intra-body communication characteristics of the heart were measured ex vivo and in vivo on porcine hearts. These findings were subsequently used to develop a leadless dual-chamber pacemaker prototype, which was tested in vivo.
Results
The pacemaker successfully performed dual-chamber pacing (D00) with wireless intra-body communication. No interference with the cardiac function was observed. The characterization measurements propose optimal communication frequencies at approximately 100 kHz or higher. The average transmission power for pacemaker synchronization can be as low as 0.1 % of the power consumption of contemporary leadless pacemakers.
Conclusions
Highly energy-efficient intra-body communication has shown to be feasible allowing leadless dual-chamber pacing. Intra-body communication may in future also enable leadless cardiac resynchronization therapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Musculoskeletal Biomechanics
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Cardiovascular Engineering (CVE)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Heart Surgery
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research

Graduate School:

Graduate School for Cellular and Biomedical Sciences (GCB)

UniBE Contributor:

Bereuter, Lukas David, Kueffer, Thomas, Niederhauser, Thomas, Fuhrer, Jürg (A), Heinisch, Paul Philipp, Zurbuchen, Adrian, Obrist, Dominik, Tanner, Hildegard, Häberlin, Andreas David Heinrich

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology
600 Technology > 620 Engineering

ISSN:

2452-302X

Publisher:

Elsevier

Language:

English

Submitter:

Lukas David Bereuter

Date Deposited:

31 Jan 2019 09:53

Last Modified:

27 Feb 2024 14:28

Publisher DOI:

10.1016/J.JACBTS.2018.07.009

PubMed ID:

30623141

BORIS DOI:

10.7892/boris.122887

URI:

https://boris.unibe.ch/id/eprint/122887

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