Design and Testing of a Transcutaneous RF Recharging System for a Fetal Micropacemaker

Vest, Adriana Nicholson; Zhou, Li; Huang, Xuechen; Norekyan, Viktoria; Bar‐Cohen, Yaniv; Chmait, Ramen H.; Loeb, Gerald E.

doi:10.1109/tbcas.2016.2620805

Cited by 17 publications

(6 citation statements)

References 18 publications

(13 reference statements)

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“…In the last animal, recharging of the micropacemaker was attempted using an external recharging ring that was specifically developed for the micropacemaker. 11 Device position and orientation were evaluated by fluoroscopy and transthoracic echocardiography to determine the optimal orientation of the recharging ring in order to recharge the micropacemaker battery. After implantation in the last animal, prolonged single-channel Holter monitoring (Ziopatch, iRhythm Technologies, Inc. San Francisco, CA) was performed in order to determine pacing and capture over time.…”

Section: Methodsmentioning

confidence: 99%

Minimally Invasive Implantation of a Micropacemaker Into the Pericardial Space

Bar‐Cohen

Silka

Hill

et al. 2018

Circ: Arrhythmia and Electrophysiology

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Background Permanent cardiac pacemakers require invasive procedures with complications often related to long pacemaker leads. We are developing a percutaneous pacemaker for implantation of an entire pacing system into the pericardial space. Methods Percutaneous micropacemaker implantations were performed in six pigs (27.4 – 34.1 kg) using subxyphoid access to the pericardial space. Modifications in the implantation methods and hardware were made after each experiment as the insertion method was optimized. In the first 5 animals, non-functional pacemaker devices were studied. In the final animal, a functional pacemaker was implanted. Results Successful placement of the entire non-functional pacing system into the pericardial space was demonstrated in 2 of the first 5 animals, and successful implantation and capture was achieved using a functional system in the last animal. A sheath was developed that allows retractable features to secure positioning within the pericardial space. In addition, a miniaturized camera with fiberoptic illumination allowed visualization of the implantation site prior to electrode insertion into myocardium. All animals studied during follow-up survived without symptoms after the initial post-operative period. Conclusions A novel micropacemaker system allows cardiac pacing without entering the vascular space nor surgical exposure of the heart. This pericardial pacemaker system may be an option for a large number of patients currently requiring transvenous pacemakers but is particularly relevant for patients with restricted vascular access, young children or those with congenital heart disease who require epicardial access.

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Section: Methodsmentioning

confidence: 99%

Minimally Invasive Implantation of a Micropacemaker Into the Pericardial Space

Bar‐Cohen

Silka

Hill

et al. 2018

Circ: Arrhythmia and Electrophysiology

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“…Unlike the postnatal setting, where analysis of the heart rhythm is done by electrocardiogram (ECG), the analysis of fetal heart rhythm is based on ultrasound [ 4 ]. Despite obvious limitations due to the difficult analysis of the fetal myocardial electric signal, a detailed analysis of fetal arrhythmia is possible using M-mode and Doppler echocardiography to assess mechanical processes [ 1 , 4 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. In the presence of a suspected or ascertained arrhythmia, the important features to be evaluated are: (1) FHR; (2) rhythm regularity; (3) the relation and time intervals of the atrial and ventricular contractions [ 13 ].…”

Section: The Use Of Ultrasound To Assess Fetal Heart Rhythmmentioning

confidence: 99%

“…There have been only rare attempts to surgically manage intractable severe fetal arrhythmia [ 9 ]. A percutaneously injectable, rechargeable fetal pacemaker was recently produced and successfully tested in an animal model [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Fetal Arrhythmias

Veduță

Panaitescu

Ciobanu

et al. 2021

JCM

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Fetal arrhythmias are mostly benign and transient. However, some of them are associated with structural defects or can cause heart failure, fetal hydrops, and can lead to intrauterine death. The analysis of fetal heart rhythm is based on ultrasound (M-mode and Doppler echocardiography). Irregular rhythm due to atrial ectopic beats is the most common type of fetal arrhythmia and is generally benign. Tachyarrhythmias are diagnosed when the fetal heart rate is persistently above 180 beats per minute (bpm). The most common fetal tachyarrhythmias are paroxysmal supraventricular tachycardia and atrial flutter. Most fetal tachycardias can be terminated or controlled by transplacental or direct administration of anti-arrhythmic drugs. Fetal bradycardia is diagnosed when the fetal heart rate is slower than 110 bpm. Persistent bradycardia outside labor or in the absence of placental pathology is mostly due to atrioventricular (AV) block. Approximately half of fetal heart blocks are in cases with structural heart defects, and AV block in cases with structurally normal heart is often caused by maternal anti-Ro/SSA antibodies. The efficacy of prenatal treatment for fetal AV block is limited. Our review aims to provide a practical guide for the diagnosis and management of common fetal arrythmias, from the joint perspective of the fetal medicine specialist and the cardiologist.

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“…And since Carpenter had performed the first implantation of a fetal pacemaker (53), some researchers have been exploring fetal pacing therapy. For example a micro-pacemaker to treat severe fetal bradycardia is currently undergoing design which may become an option in the future (54). administered after due evaluation of the potential adverse effects and benefits of dexamethasone.…”

Section: Sinus Bradycardiamentioning

confidence: 99%

Prenatal Management Strategy for Immune-Associated Congenital Heart Block in Fetuses

Liao

Tang

Qiao

et al. 2021

Front. Cardiovasc. Med.

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Fetal congenital heart block (CHB) is the most commonly observed type of fetal bradycardia, and is potentially life-threatening. More than 50% of cases of bradycardia are associated with maternal autoimmunity, and these are collectively termed immune-associated bradycardia. Several methods have been used to achieve reliable prenatal diagnoses of CHB. Emerging data and opinions on pathogenesis, prenatal diagnosis, fetal intervention, and the prognosis of fetal immune-associated CHB provide clues for generating a practical protocol for clinical management. The prognosis of fetal immune-associated bradycardia is based on the severity of heart blocks. Morbidity and mortality can occur in severe cases, thus hieratical management is essential in such cases. In this review, we mainly focus on optimal strategies pertaining to autoimmune antibodies related to CHB, although the approaches for managing autoimmune-mediated CHB are still controversial, particularly with regard to whether fetuses benefit from transplacental medication administration. To date there is still no accessible clinical strategy for autoimmune-mediated CHB. This review first discusses integrated prenatal management strategies for the condition. It then provides some advice for clinicians involved in management of fetal cardiovascular disorder.

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Design and Testing of a Transcutaneous RF Recharging System for a Fetal Micropacemaker

Cited by 17 publications

References 18 publications

Minimally Invasive Implantation of a Micropacemaker Into the Pericardial Space

Minimally Invasive Implantation of a Micropacemaker Into the Pericardial Space

Treatment of Fetal Arrhythmias

Prenatal Management Strategy for Immune-Associated Congenital Heart Block in Fetuses

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