Northwestern University and George Washington University (GW) have created the first ever transient pacemaker. This is a wireless, battery-free, implantable pacemaker that can be discarded after its use has ended.Patients who require temporary pacing while they wait for a permanent pacemaker or after cardiac surgery can use the lightweight, thin and flexible device. The pacemaker's components are biocompatible, and will naturally absorb into the body's biofluids in five to seven weeks. No need for surgical removal.Near-field communication protocols are used to wirelessly harvest energy from an external antenna. This technology is also used in RFID tags and smartphones for electronic payments. This eliminates the need to use bulky batteries or rigid hardware (including wires) and leads. Leads can cause infections and can also become encased in scar tissue. This can lead to further damage if they are removed.Nature Biotechnology will publish the study on June 28th. The paper shows the effectiveness of the device across a variety of small and large animal models.John A. Rogers from Northwestern, who developed the device, said that "hardware placed near or in the heart creates risk for infection and other complications." Our wireless, transient pacemakers eliminate the need for percutaneous leads to perform surgical extractions. This allows us to overcome the key drawbacks of traditional temporary devices and offers the possibility for lower costs and better outcomes for patients. This unique device could be the future of temporary pacemaking technology."Some patients only require pacemakers temporarily, possibly after open heart surgery or a drug overdose," Dr. Rishi Arora, a Northwestern Medicine cardiologist, said. We can remove the pacemaker after the patient's heart has stabilized. Current care is to insert a wire that stays in place for between three and seven days. They could become infected, or even dislodged."The transient electronic platform opens an entirely new chapter of medicine and biomedical research," stated Igor Efimov from GW, who was co-led the study along with Rogers and Arora. "The bioresorbable material at the foundation this technology makes it possible to create a whole host of diagnostic or therapeutic transient devices for monitoring progress of diseases and therapies, delivering electro, pharmacological and cell therapies and gene reprogramming.AdvertisementRogers is the Louis Simpson and Kimberly Querrey professor of Materials Science and Engineering and Biomedical Engineering and Neurological Surgery at the McCormick School of Engineering and Feinberg School of Medicine. He also directs the Querrey Simpson Institute for Bioelectronics. Arora is a professor at Feinberg of medicine and co-director for the Center for Arrhythmia Research. Efimov is the Alisann & Terry Collins Professor in Biomedical Engineering at GW.Refrain from restrictive and risky leadTemporary pacemaker electrodes are currently required to establish a temporary pacing system after open heart surgery. These leads connect to an external pacemaker box, which delivers current to the heart.Physicians can remove pacemaker electrodes from temporary pacemakers when they are no longer required. Implanted temporary pacemakers can cause infection, bleeding, blood clots, and tissue damage. Although these complications are rare, they can be dangerous.The transient pacemaker from Northwestern and GW allows surgeons and patients to avoid this potentially dangerous procedure. The implantable device weighs less than half of a gram and is 250 microns thick. It is flexible and soft, and encapsulates electrodes which are softly laminated onto the heart's surface to deliver an electric pulse.AdvertisementArora stated that instead of using wires which can become infected or dislodged we can implant this leadless, biocompatible pacemaker. The circuitry is placed directly on the heart's surface and can be activated remotely. This new pacemaker is able to 'dissolve' or degrade on its own over a few weeks. It can also be activated remotely, so there's no need to remove pacemaker electrodes. This could be a significant victory for patients who have had their pacemaker electrodes removed.He said that it was possible to eventually implant bioresorbable pacemakers via a vein in an arm or leg. In this case, temporary pacing may also be possible for patients with a history of heart disease or patients undergoing catheter-based procedures such as trans-catheter valve replacement.Comfort of patients is a priorityDr. Duc Thinh Pham of Northwestern Medicine, a cardiac surgeon, believes that a temporary pacemaker would be more beneficial for his patients. Patients often feel discomfort for several days after pacemakers are installed. To prevent leads from slipping, patients must restrict their movement and activities.Pham, who has performed over 2,000 cardiac surgery procedures in his career, said that "this transient pacemaker" is brilliant. The device not only addresses the issue of patients who require temporary pacing after a cardiac surgery, but also addresses the secondary issue, which is patient comfort and their ability to move around freely. This device can greatly improve the patient's post-operative experience if it is successful.Act of DisappearanceThis is the second instance of bioresorbable electronics medicine from Rogers' lab. The Rogers lab has been studying transient electronic phenomena for more than a decade. Rogers and his colleagues presented the world's first bioresorbable electronics device, a biodegradable implant which speeds up nerve regeneration. The bioresorbable electronic devices developed by the team are virtually indestructible, similar to absorbable stitches. The devices are completely destroyed by the body's natural biological process after they have been fully degraded."There is clearly need for better temporary heart pacemakers," stated Dr. Bradley Knight (the Chester C. Cooley and Deborah M. Cooley distinguished professor of cardiology at Feinberg, and coauthor of this study. Professor Rogers was the first to contact me about the bioresorbable nerve stimulationator. He wanted to know if this could be used to pace the heart. As a proof-of-concept, he had already begun to work with Dr. Efimov on a small bioresorbable pacemaker. The two teams worked together to create a larger bioresorbable, leadless cardiac pacemaker that could be used on a human scale. This is a wonderful example of the collaboration between engineering and medicine at Northwestern.A temporary pacemaker may be required depending on the patient. It can last anywhere from a few days to several weeks. Rogers' team can adjust the thickness and composition of the materials to control how long it stays functional before it dissolves.Rogers stated that the devices are made from safe and bioresorbable materials. The optimized architectures allow for stable operation over longer periods than clinically required. We can customize the devices to cover a wide range of relevant lifetimes. In general, transient technologies could one day provide treatment or therapy for a wide range of medical conditions. It is a form of engineering medicine.
