Super-selective electrical stimulation of the left ventricle via a miniaturized magnetized stimulation wire: proof of concept study.
Summary of "Super-selective electrical stimulation of the left ventricle via a miniaturized magnetized stimulation wire: proof of concept study."
Abstract Cardiac resynchronization therapy provides a treatment option for patients with congestive heart failure. Electrodes are usually advanced via the cardiac venous system (CVS). Placement is often hampered by small vessel diameter or tortuosity. The aim of this study was to develop and test a magnetized stimulation wire (MSW) capable of being navigated into small and tortuous CVS branches. Therefore, a conventional guide wire with a permanent magnet and a single stimulation electrode at its tip was coated with iridium oxide at the distal end and insulated except for the very tip (coating thickness: 500 nm, active uncoated area: 10 mm(2)). The MSW was designed to allow for a remote magnetic steering using a magnetic navigation system (MN) (Stereotaxis). After in vitro testing of the electrical properties, the MSW was tested in an animal model (n=6 sheep): the MSW was placed in a CVS side branch and navigation characteristics of the MSW were determined. The effective (unipolar) pacing threshold was 4.9+/-2.4 V (at 2 ms pulse width). The rheobase was 1.89+/-0.44 V and the chronaxie time was 0.75+/-0.7 ms. The MSW could be navigated into small CVS branches with reasonable MN properties. This could allow stimulation at CVS sites currently not accessible for conventional stimulation catheters or electrodes.
Affiliation
Department of Cardiology, RWTH Aachen University, Aachen, Germany.
Journal Details
This article was published in the following journal.
Name: Biomedizinische Technik. Biomedical engineering
ISSN: 1862-278X
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20731526
- DOI: http://dx.doi.org/10.1515/BMT.2010.039
Medical and Biotech [MESH] Definitions
Evoked Potentials, Motor
The electrical response evoked in a muscle or motor nerve by electrical or magnetic stimulation. Common methods of stimulation are by transcranial electrical and TRANSCRANIAL MAGNETIC STIMULATION. It is often used for monitoring during neurosurgery.
Tricuspid Atresia
Absence of the orifice between the RIGHT ATRIUM and RIGHT VENTRICLE, with the presence of an atrial defect through which all the systemic venous return reaches the left heart. As a result, there is left ventricular hypertrophy (HYPERTROPHY, LEFT VENTRICULAR) because the right ventricle is absent or not functional.
Aortic Valve
The valve between the left ventricle and the ascending aorta which prevents backflow into the left ventricle.
Ventricular Remodeling
The geometric and structural changes that the HEART VENTRICLES undergo, usually following MYOCARDIAL INFARCTION. It comprises expansion of the infarct and dilatation of the healthy ventricle segments. While most prevalent in the left ventricle, it can also occur in the right ventricle.
Heart Ventricles
The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.
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