An In Vivo Study of Cardiac Pacemaker Optimization by Pulse Shape Modification

Klafter, Richard D.; Hrebien, Leonid

doi:10.1109/tbme.1976.324636

Cited by 19 publications

(7 citation statements)

References 9 publications

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“…In an analytical nerve membrane model, the optimal waveform was found to be an exponentially rising waveform (Jezernik and Morari, 2005; Jezernik et al , 2010). This waveform has also demonstrated decreased energy consumption in vivo (Klafter and Hrebien, 1976). In a simulated membrane patch model, rectangular, sinusoidal, Gaussian and exponentially increasing waveforms all demonstrated reduced energy requirements, depending on the stimulation pulse width under consideration (Sahin and Tie, 2007).…”

Section: Introductionmentioning

confidence: 98%

Evaluation of novel stimulus waveforms for deep brain stimulation

2010

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Deep brain stimulation (DBS) is an established therapy for the treatment of a wide range of neurological disorders. Historically, DBS and other neurostimulation technologies have relied on rectangular stimulation waveforms to impose their effects on the nervous system. Recent work has suggested that non-rectangular waveforms may have advantages over the traditional rectangular pulse. Therefore, we used detailed computer models to compare a range of charge-balanced biphasic waveforms with rectangular, exponential, triangular, Gaussian, and sinusoidal stimulus pulse shapes. We explored the neural activation energy of these waveforms in both intracellular and extracellular stimulation. In the context of extracellular stimulation, we compared their effects on both axonal fibers of passage and projection neurons. Finally, we evaluated the impact of delivering the waveforms through a clinical DBS electrode, as opposed to a theoretical point source. Our results suggest that DBS with a 1 ms centered-triangular pulse can decrease energy consumption by 64 % when compared to the standard 100 μs rectangular pulse (energy cost of 48 nJ and 133 nJ, respectively, to stimulate 50 % of a distributed population of axons) and can decrease energy consumption by 10 % when compared to the most energy efficient rectangular pulse (1.25 ms duration). In turn, there may be measureable energy savings when using appropriately designed non-rectangular pulses in clinical DBS applications, thereby warranting further experimental investigation.

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Section: Introductionmentioning

confidence: 98%

Evaluation of novel stimulus waveforms for deep brain stimulation

2010

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“…In this work, we used only rectangular pulses for stimulation and have not examined possibilities for other, energetically favorable pulse shapes 19,20 . Since all experiments must be performed while the cells were viable, the imposed time constraints made it impossible to test a variety of waveforms.…”

Section: Discussionmentioning

confidence: 99%

Energy-efficiency of Cardiomyocyte Stimulation with Rectangular Pulses

Laasmaa¹,

Lu²,

Veletić³

et al. 2019

Sci Rep

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In cardiac pacemaker design, energy expenditure is an important issue. This work aims to explore whether varying stimulation pulse configuration is a viable optimization strategy for reducing energy consumption by the pacemaker. A single cardiomyocyte was used as an experimental model. Each cardiomyocyte was stimulated with different stimulation protocols using rectangular waveforms applied in varying number, in short succession. The amplitude, the width of each pulse, and the interval between consecutive pulses were modified. The application of multiple pulses in a short sequence led to a reduction of the threshold voltage required for stimulation when compared to a single pulse. However, none of the employed multi-pulse sequences reduced the overall energy expenditure of cell stimulation when compared to a single pulse stimulation. Among multiple pulse protocols, a combination of two short pulses (1 ms) separated with a short interval (0.5 ms) had the same energy requirements as a single short pulse (1 ms), but required the application of significantly less voltage. While increasing the number of consecutive pulses does not reduce the energy requirements of the pacemaker, the reduction in threshold voltage can be considered in practice if lower stimulation voltages are desired.

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“…This approach contrasts with that employed by present-day pacemakers, which stimulate a cardiac tissue by applying electrical field without cell puncturing. We use the same, electric field-based stimulation strategy for in-vitro cell experiments ( To test how different pulses affect the energy consumption of the nanoactuator, we compare the excitatory effects of rectangular-, sine-, half-sine-, and sawtooth pulses and their influence to the excitation of cardiomyocyte(s) in terms of the energy used [33], [34]. Fig.…”

Section: In-silico Cell Stimulationmentioning

confidence: 99%

Multi-nodal nano-actuator pacemaker for energy-efficient stimulation of cardiomyocytes

Lu¹,

Veletić²,

Laasmaa³

et al. 2019

Nano Communication Networks

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There is continuous interest in maximizing the longevity of implantable pacemakers, which are effective in remedying and managing patients with arrhythmic heart disease. This paper accordingly first proposes miniature actuating nanomachines that interconnect with individual cardiomyocytes and then deeply explores their energy expenditure when performing basic cardiomyocyte stimulation tasks. Since evoked electrical impulses from a number of actuated cardiomyocytes could coordinate contraction throughout the remaining heart muscle and lead to a heart beat, the miniature actuating nanomachines acting synchronously form a conceptual multi-nodal nano-actuator pacemaker network.

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An In Vivo Study of Cardiac Pacemaker Optimization by Pulse Shape Modification

Cited by 19 publications

References 9 publications

Evaluation of novel stimulus waveforms for deep brain stimulation

Evaluation of novel stimulus waveforms for deep brain stimulation

Energy-efficiency of Cardiomyocyte Stimulation with Rectangular Pulses

Multi-nodal nano-actuator pacemaker for energy-efficient stimulation of cardiomyocytes

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