Thanks to the scientists of the universities Northwestern is George Washington (GW), the biomedical technology achieved an important result: the first was developed transient pacemaker capable of self-dissolving in the organism in a completely harmless way, after having carried out its task.
The study was published in the scientific journal Nature Biotechnology.
Transient Pacemaker: How It Is and How It Works
It is a thin, flexible and lightweight device with wireless stimulation, without batteries and fully implantable that disappears when it is no longer needed. The goal is to implant it in patients who need temporary pacing after heart surgery or waiting for a permanent pacemaker.
All components of the provisional pacemaker are biocompatible and naturally absorb into the body’s biofluids over the course of five to seven weeks, without the need for surgical explant..
The device collects energy wirelessly from a remote external antenna using near-field communication protocols, the same technology used in smartphones for electronic payments and RFID tags. This dynamic eliminates the need for bulky batteries and rigid hardware, including cables that can introduce infections but can also get wrapped in scar tissue, causing further damage once removed.
John A. Rogers of Northwestern, who led the development of the device, said: “Hardware placed in or near the heart creates risks of infection and other complications. Our wireless and transient pacemakers overcome the major disadvantages of traditional temporary devices by eliminating the need for percutaneous leads for surgical extraction procedures, thus offering the potential to reduce costs and improve patient care outcomes. This unusual type of device could represent the future of temporary rhythm technology devices ”.
dr. Rishi Arora, cardiologist of the Northwestern Medicine who co-directed the study, explained: “Sometimes patients need pacemakers only temporarily, perhaps after open heart surgery, a heart attack, or an overdose of medications. After the patient’s heart has stabilized, we can remove the pacemaker. The current standard of care involves inserting a wire, which stays in place for three to seven days. These can be infected or removed ”.
“The transitional electronic platform opens a completely new chapter in medicine and biomedical research “, he has declared Igor Efimov by GW, who co-directed the studio with Rogers and Arora. “The bioabsorbable materials underlying this technology allow the creation of a whole range of diagnostic and therapeutic transient devices to monitor the progression of diseases and therapies, providing electrical, drug, cellular, gene reprogramming and more therapies.”
To date, to set up temporary pacing after open heart surgery, surgeons have to sew electrodes of a temporary pacemaker onto the heart muscle. These have cables exiting from the front of the patient’s chest, connecting to an external pacing box that provides a current to control the heart rhythm. Once the temporary pacemaker is no longer needed, doctors remove the pacemaker electrodes. Although uncommon, the potential complications of implanted temporary pacemakers include infection, dislocation, torn or damaged tissue, bleeding, and blood clots.
With the transient pacemaker developed by researchers at Northwestern and GW universities, surgeons and patients can avoid this potentially risky procedure. The fully implantable device is light and thin: 250 microns thick and weighs less than half a gram. Soft and flexible, it encapsulates electrodes that gently laminate to the surface of the heart to deliver an electrical impulse.
“Instead of using wires that can be infected and removed, we can implant this lead-free biocompatible pacemaker “, Arora specified. “The circuit is implanted directly on the surface of the heart and we can activate it remotely. Over a period of weeks, this new type of pacemaker “dissolves” or degrades on its own, thus avoiding the need for physical removal of the pacemaker. electrodes This is potentially a major victory for post-operative patients ”.
“With further modifications, it may eventually be possible to implant such bioabsorbable pacemakers through a vein in the leg or arm.“, he added. “In this case, it may also be possible to provide temporary stimulation to patients who have suffered a heart attack or to patients undergoing catheter-based procedures, such as trans-catheter aortic valve replacement.
The cardiac surgeon of the Northwestern Medicine, Dr. Duc Thinh Pham, who did not participate in the development of the device, he speculated that a transient pacemaker would undoubtedly make his patients more comfortable. With current pacemakers, patients often experience discomfort for days after lead insertion. Hence, they have to limit their movements and activities to prevent the cables from shifting.
“This transient pacemaker is exceptional“Said Pham, who has performed more than 2,000 cardiac surgeries over the course of his career. “In addition to addressing the main problem of occasional post-operative cardiac patients who require temporary pacing due to blockages or arrhythmias, the device addresses the secondary problem of patient comfort, the ability to move freely and to rehabilitate. If successful, this device will significantly improve the patient’s post-operative course ”.
Transient pacemaker – this is how it disappears from the body
This is the second example of bioabsorbable electronic medicine since Rogers laboratory, who has been studying transient electronics for over a decade. In 2018, Rogers and colleagues demonstrated the world’s first bioabsorbable electronic device, a biodegradable implant that accelerates nerve regeneration. The team’s bioabsorbable devices are completely harmless, similar to resorbable stitches. After being completely degraded, the devices disappear completely through the body’s natural biological processes.
“There is clearly a need for better temporary cardiac pacemakers “, said Dr. Bradley Knight, Chester C. Professor of Cardiology and Deborah M. Cooley in Feinberg and co-author of the study. “When I first learned of bioabsorbable nerve stimulator, I contacted Professor Rogers to explore the possibility of using this technology to stimulate the heart. He had already started working with Dr. Efimov to develop a reduced version of a bioabsorbable pacemaker as a proof of concept. We then worked with both teams to develop a larger version of a lead-free, bioabsorbable cardiac pacemaker that could be effective on a human scale. It’s a great example of what we can create at Northwestern by combining engineering and medical expertise. “
Depending on the patient, a temporary pacemaker may be needed from a couple of days to several weeks. By varying the composition and thickness of the materials in the device, Rogers’ team can control the precise number of days it remains functional before dissolving.
“We build these devices with different types of safe, bioabsorbable materials and in optimized architectures to ensure stable operation for a slightly longer period of time than is clinically necessary”, Rogers said. “We can adapt devices to address a broad spectrum of relevant lives. Transitional technologies, in general, could someday provide therapy or treatment for a wide variety of medical conditions, serving, in a sense, as an engineering form of medicine. “