In a proof-of-concept study that aims to address the unmet need for minimally invasive cardiac control and monitoring devices, researchers have developed a network of wireless devices, including a bioresorbable pacemaker, that can temporarily monitor and control heart rate.
As their technology is wireless, it could circumvent common shortcomings of implanted devices, such as drive-line infections or the need for surgical procedures to remove or replace pacemaker leads or batteries, for example. Most medical devices used to provide electrical pacing of the heart, particularly temporary solutions for patients recovering from cardiac surgery, require a combination of internal hardware connected to external power and control systems by way of wired leads that penetrate the skin. Such devices introduce infection risks and limit a patient's mobility, and they require surgical extraction procedures, which can introduce further complications.
Here, Yeon Choi and colleagues present a design for a biodegradable, closed-loop, wireless micro-electro-mechanical system (Bio-MEMS) for minimally invasive heart monitoring and control. Using water soluble metals and degradable polymers, Choi et al. created a fully implantable and bioresorbable module that wirelessly receives power through the skin for epicardial pacing. For real-time data visualization and algorithmic control, it features an integrated network of skin surface-interfaced sensors that collect and transmit data to an external control module via Bluetooth. After therapy, the internal module dissolves in the body and the skin-interfaced modules are removed by peeling them off the skin, eliminating the need for surgical removal. To demonstrate proof of concept, the authors used the device to monitor and control heart pacing in rat, canine and ex-vivo human heart studies.
"Triggering electrical pulsing in response to sensing defined biosignals adds a new layer of complexity to human-machine interfacing. But is such a disruptive technology ready to be deployed in clinical practice?" writes Wolfram-Hubertus Zimmermann in a related Perspective. "There are a number of key issues that need to be addressed: the degree to which the obtained data are reliable, how safety and effectiveness can be ensured, and how misuse can be prevented."
Choi, Y.S., et al. (2022) A transient, closed-loop network of wireless, body-integrated devices for autonomous electrotherapy. Science. doi.org/10.1126/science.abm1703.