A bioadhesive pacing lead for atraumatic cardiac monitoring and stimulation in rodent and porcine models

J. Deng, J. Wu, X. Chen, T. Sarrafian, C. Varela, W. Whyte, C. Guo, E. Roche, L. Griffiths*, H. Yuk*, C. Nabzdyk*, X. Zhao*

Editor’s summary

Temporary epicardial pacing leads provide short-term monitoring and stimulation for cardiac electrophysiological abnormalities. Clinically adopted pacing leads involve puncture of the cardiac tissue by direct electrode insertion or suture. Deng et al. developed a 3D-printed adhesive polymeric pacing lead that supported minimally invasive implantation on the epicardial surface and on-demand detachment to reduce the potential for tissue damage. In rat and porcine models, the adhesive pacing lead demonstrated strong adhesion to cardiac tissue and did not cause macroscopic tissue damage or bleeding with adhesion or on-demand removal. The device integrated with existing clinical pacing equipment and provided a stable electrical interface for cardiac monitoring and pacing for 10 to 14 days in rat and porcine models. These studies provide proof of principle for the use of printable adhesive electronics for cardiac pacing applications. —Molly Ogle

Abstract

Current clinically used electronic implants, including cardiac pacing leads for epicardial monitoring and stimulation of the heart, rely on surgical suturing or direct insertion of electrodes to the heart tissue. These approaches can cause tissue trauma during the implantation and retrieval of the pacing leads, with the potential for bleeding, tissue damage, and device failure. Here, we report a bioadhesive pacing lead that can directly interface with cardiac tissue through physical and covalent interactions to support minimally invasive adhesive implantation and gentle on-demand removal of the device with a detachment solution. We developed 3D-printable bioadhesive materials for customized fabrication of the device by graft-polymerizing polyacrylic acid on hydrophilic polyurethane and mixing with poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) to obtain electrical conductivity. The bioadhesive construct exhibited mechanical properties similar to cardiac tissue and strong tissue adhesion, supporting stable electrical interfacing. Infusion of a detachment solution to cleave physical and covalent cross-links between the adhesive interface and the tissue allowed retrieval of the bioadhesive pacing leads in rat and porcine models without apparent tissue damage. Continuous and reliable cardiac monitoring and pacing of rodent and porcine hearts were demonstrated for 2 weeks with consistent capture threshold and sensing amplitude, in contrast to a commercially available alternative. Pacing and continuous telemetric monitoring were achieved in a porcine model. These findings may offer a promising platform for adhesive bioelectronic devices for cardiac monitoring and treatment. 【原文链接】