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Article: First Human Demonstration of Cardiac Stimulation With Transcutaneous Ultrasound Energy Delivery. Implications for Wireless Pacing With Implantable Devices

TitleFirst Human Demonstration of Cardiac Stimulation With Transcutaneous Ultrasound Energy Delivery. Implications for Wireless Pacing With Implantable Devices
Authors
Issue Date2007
PublisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jac
Citation
Journal Of The American College Of Cardiology, 2007, v. 50 n. 9, p. 877-883 How to Cite?
AbstractObjectives: The purpose of this study was to evaluate the feasibility and safety of a novel technology that uses energy transfer from an ultrasound transmitter to achieve cardiac stimulation without the use of a pacing lead in humans. Background: To overcome the limitations of pacemaker leads, a new technology enabling stimulation without the use of a lead is desirable. Methods: A steerable bipolar electrophysiology catheter incorporating a receiver electrode into the tip and circuitry to convert ultrasound energy to electrical energy was inserted transvenously into the heart. An ultrasound transmitting transducer was placed on the chest wall with ultrasound gel. Ultrasound energy was amplitude-adjusted and transmitted at 313 to 385 kHz. The output waveform of the receiver electrode was monitored while the transmitter was moved on the chest wall to target the receiver. The ultrasound transmission amplitude was limited to a mechanical index of 1.9, the maximum allowed for ultrasound imaging systems. Ultrasound-mediated pacing with minimum voltage but consistent capture was obtained for 12 s. Results: Twenty-four patients (48 ± 12 years) were tested during or after completion of clinical electrophysiology procedures. A total of 80 pacing sites were tested (mean 3.3 sites/patient): 12 right atrial, 35 right ventricular, and 33 left ventricular (31 endocardial) sites. The transmit-to-receive distance was 11.3 ± 3.2 cm (range 5.3 to 22.5 cm). Ultrasound-mediated pacing was achieved at all 80 test sites, with consistent capture at 77 sites. The mechanical index during pacing was 0.5 ± 0.3 (range 0.1 to 1.5). The mean ultrasound-mediated capture threshold was 1.01 ± 0.64 V. There was no adverse event related to ultrasound pacing. No patient experienced discomfort during pacing. Conclusions: The feasibility and safety of pacing usng ultrasound energy has been shown acutely. © 2007 American College of Cardiology Foundation.
Persistent Identifierhttp://hdl.handle.net/10722/163100
ISSN
2015 Impact Factor: 17.759
2015 SCImago Journal Rankings: 10.097
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLee, KLen_US
dc.contributor.authorLau, CPen_US
dc.contributor.authorTse, HFen_US
dc.contributor.authorEcht, DSen_US
dc.contributor.authorHeaven, Den_US
dc.contributor.authorSmith, Wen_US
dc.contributor.authorHood, Men_US
dc.date.accessioned2012-09-05T05:27:36Z-
dc.date.available2012-09-05T05:27:36Z-
dc.date.issued2007en_US
dc.identifier.citationJournal Of The American College Of Cardiology, 2007, v. 50 n. 9, p. 877-883en_US
dc.identifier.issn0735-1097en_US
dc.identifier.urihttp://hdl.handle.net/10722/163100-
dc.description.abstractObjectives: The purpose of this study was to evaluate the feasibility and safety of a novel technology that uses energy transfer from an ultrasound transmitter to achieve cardiac stimulation without the use of a pacing lead in humans. Background: To overcome the limitations of pacemaker leads, a new technology enabling stimulation without the use of a lead is desirable. Methods: A steerable bipolar electrophysiology catheter incorporating a receiver electrode into the tip and circuitry to convert ultrasound energy to electrical energy was inserted transvenously into the heart. An ultrasound transmitting transducer was placed on the chest wall with ultrasound gel. Ultrasound energy was amplitude-adjusted and transmitted at 313 to 385 kHz. The output waveform of the receiver electrode was monitored while the transmitter was moved on the chest wall to target the receiver. The ultrasound transmission amplitude was limited to a mechanical index of 1.9, the maximum allowed for ultrasound imaging systems. Ultrasound-mediated pacing with minimum voltage but consistent capture was obtained for 12 s. Results: Twenty-four patients (48 ± 12 years) were tested during or after completion of clinical electrophysiology procedures. A total of 80 pacing sites were tested (mean 3.3 sites/patient): 12 right atrial, 35 right ventricular, and 33 left ventricular (31 endocardial) sites. The transmit-to-receive distance was 11.3 ± 3.2 cm (range 5.3 to 22.5 cm). Ultrasound-mediated pacing was achieved at all 80 test sites, with consistent capture at 77 sites. The mechanical index during pacing was 0.5 ± 0.3 (range 0.1 to 1.5). The mean ultrasound-mediated capture threshold was 1.01 ± 0.64 V. There was no adverse event related to ultrasound pacing. No patient experienced discomfort during pacing. Conclusions: The feasibility and safety of pacing usng ultrasound energy has been shown acutely. © 2007 American College of Cardiology Foundation.en_US
dc.languageengen_US
dc.publisherElsevier Inc. The Journal's web site is located at http://www.elsevier.com/locate/jacen_US
dc.relation.ispartofJournal of the American College of Cardiologyen_US
dc.subject.meshAdulten_US
dc.subject.meshArrhythmias, Cardiac - Therapyen_US
dc.subject.meshCardiac Pacing, Artificial - Methodsen_US
dc.subject.meshCatheter Ablationen_US
dc.subject.meshElectrodes, Implanteden_US
dc.subject.meshElectrophysiologic Techniques, Cardiacen_US
dc.subject.meshEquipment Designen_US
dc.subject.meshFeasibility Studiesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPacemaker, Artificialen_US
dc.subject.meshTachycardia, Atrioventricular Nodal Reentry - Surgeryen_US
dc.subject.meshTransducersen_US
dc.subject.meshUltrasonicsen_US
dc.subject.meshUltrasonography, Interventional - Instrumentationen_US
dc.titleFirst Human Demonstration of Cardiac Stimulation With Transcutaneous Ultrasound Energy Delivery. Implications for Wireless Pacing With Implantable Devicesen_US
dc.typeArticleen_US
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_US
dc.identifier.authorityTse, HF=rp00428en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.jacc.2007.04.081en_US
dc.identifier.pmid17719475-
dc.identifier.scopuseid_2-s2.0-34547931047en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34547931047&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume50en_US
dc.identifier.issue9en_US
dc.identifier.spage877en_US
dc.identifier.epage883en_US
dc.identifier.isiWOS:000248960200010-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLee, KL=7501505962en_US
dc.identifier.scopusauthoridLau, CP=7401968501en_US
dc.identifier.scopusauthoridTse, HF=7006070805en_US
dc.identifier.scopusauthoridEcht, DS=7004097811en_US
dc.identifier.scopusauthoridHeaven, D=6602083795en_US
dc.identifier.scopusauthoridSmith, W=7406473145en_US
dc.identifier.scopusauthoridHood, M=7006920090en_US

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