Ventricular tachyarrhythmia treatment and prevention by subthreshold stimulation with stretchable epicardial multichannel electrode array
Conventional intracardiac electronics have a limited approach pathway and necessitate high-energy electric stimulation for pacing and cardioversion, which poses a risk of recurrent arrhythmias or potential myocardial damage.
In this research, we propose an epicardial soft electrode array that records electrophysiological signals from the entire myocardium and local myocardial tissue simultaneously. This enables the diagnosis of ventricular arrhythmias and the delivery of subthreshold stimulation to terminate and prevent ventricular arrhythmia events with minimal energy.
The epicardial electrode array identifies the infarction area by analyzing information that includes propagation speed and threshold voltage.
During a ventricular arrhythmic event, the epicardial electrode array detects the arrhythmic focus by analyzing propagation speed.
Subthreshold stimulation refers to electric stimulation that does not induce activation and propagation of myocardial tissue.
The stimulation protocol, beginning with subthreshold stimulation, successfully terminates 43% of ventricular arrhythmic events, leaving only 18% of the ventricular arrhythmias unmitigated. This outcome suggests that ventricular arrhythmic events can be effectively terminated using minimal, painless electric stimulation.
Continuous subthreshold stimulation applied to the left ventricle with myocardial infarction (MI) can significantly decrease the risk of ventricular arrhythmias. This approach leads to a notable 70% reduction in ventricular tachycardia incidence when compared to the control group.