Electronic sensor and actuator webs for large-area complex geometry cardiac mapping and therapy

Abstract

Curved surfaces, complex geometries, and time-dynamic deformations of the heart create challenges in establishing intimate, nonconstraining interfaces between cardiac structures and medical devices or surgical tools, particularly over large areas. We constructed large area designs for diagnostic and therapeutic stretchable sensor and actuator webs that conformally wrap the epicardium, establishing robust contact without sutures, mechanical fixtures, tapes, or surgical adhesives. These multifunctional web devices exploit open, mesh layouts and mount on thin, bio-resorbable sheets of silk to facilitate handling in a way that yields, after dissolution, exceptionally low mechanical moduli and thicknesses. In vivo studies in rabbit and pig animal models demonstrate the effectiveness of these device webs for measuring and spatially mapping temperature, electrophysiological signals, strain, and physical contact in sheet and balloon-based systems that also have the potential to deliver energy to perform localized tissue ablation.flexible electronics | semiconductor nanomaterials | stretchable electronics | implantable biomedical devices | cardiac electrophysiology C ardiac arrhythmias occur in all component structures and 3D regions of the heart, resulting in significant challenges in diagnosis and treatment of precise anatomic targets (1). Many common arrhythmias, including atrial fibrillation and ventricular tachycardia, originate in endocardial substrates and then propagate in the transverse direction to affect epicardial regions (1, 2). Characterizing arrhythmogenic activity at specific regions of the heart is thus critical for establishing the basis for definitive therapies such as cardiac ablation (3). Advanced tools that offer sufficient spatial resolution (<1 mm) and intimate mechanical coupling with myocardial tissue, but without undue constraints on natural motions, would therefore be of great clinical importance (4-6). To date, cardiac ablation procedures have largely relied on point ablation catheters deployed in the endocardial space (1, 5, 7-9). Although successful in the treatment of simple arrhythmias originating in and around the pulmonary veins, these devices are poorly suited for treating complex arrhythmias, such as persistent atrial fibrillation (10-13), that arise from various sites inside the left atrium. Other classes of devices have demonstrated the utility of spatiotemporal voltage mapping using various modes of operation, including noninvasive surface mapping designs (14, 15), epicardial voltage-mapping "socks" (16-20), and endocardial contact and noncontact catheters, with densities approaching 64 electrodes (21-31). These solutions all exploit arrays of passive metal wirebased electrodes integrated on wearable vests and socks (14-20) or catheter systems (21-26) for mapping of complex arrhythmias. Building such mesh structures requires manual assembly and is only possible because the individual wires are millimeter scale in diameter and thus sufficiently large to be threaded to form a mesh.Fo...

Stretchable silicon nanoribbon electronics for skin prosthesis

“…6c,d). In the future, it is necessary to incorporate strain gauges in rosette configurations 28 to measure strain distribution in the arbitrary xy coordinate plane to characterize plane strain of prosthetic skin ( Supplementary Fig. 7).…”

Stretchable Magnetoelectronics

“…Approaches that enable self-healing 64 will lead to durable and multifunctional artificial skin. In addition to being wearable, e-skins can also be operated in vivo as bio-integrated electronics 65,66 enabling highly functional and compliant diagnostic or therapeutic implants 47 as well as advanced surgical tools 67 . Another novel and highly innovative field of prospective applications for stretchable electronics is soft robotics 69,71 and particularly elastomeric actuators 39,72 .…”

High-performance giant magnetoresistive sensorics on flexible Si membranes

“…Flexible electronics [1][2][3][4] is a rapidly evolving field that has given rise to new integration possibilities of electronic circuitry for applications requiring mechanical stress and deformation, such as flexible displays, 5 electronic skin, 6,7 biomedical applications, 8,9 and energy harvesting devices. 10 The family of flexible devices will not be complete without navigation modules, body tracking, and position monitoring systems.…”