Available at: https://digitalcommons.calpoly.edu/theses/431
Date of Award
MS in Engineering - Bioengineering
The human body is a well tuned mechanism where systems work in synergy to provide a healthy quality of life. The human circulatory system transports oxygenated blood from the heart to the rest of the body delivering the proper nutrients for cells to function. When the heart malfunctions, serious complications can arise leading to sudden cardiac arrest. Congestive heart failure (CHF) is one heart disease that affects the synchrony of the heart’s ventricles.
Cardiac resynchronization therapy (CRT) has been widely accepted as a treatment for CHF. Similar to traditional dual chamber pacing techniques, CRT adds a pacing lead to stimulate the left ventricle. Left ventricular leads are implanted via the coronary sinus which provides the easiest surgical access to the left ventricle. Another option for LV pacing is by using an epicardial lead. This option has proven to be safe and effective but requires major surgery. An epicardial lead is usually implanted by performing a thoracotomy. Many studies have been done to show the benefits of bi-ventricular pacing, therefore developing new methods to gain LV access safely and reliable are highly desirable.
The epicardial satellite pacemaker, or EPI pacemaker, is a component of a larger CRT system. This implantable cardiac system is composed of a master pacing unit with leads and a remote satellite pacing unit. The master unit is a traditional CRT device electrically coupled to the right side of the heart. It controls the right atrium and ventricle via transvenous leads anchored to the endocardium of the heart. The master device generates the pacing pulses to stimulate the right atrium and right ventricle and a communications module to transmit pacing commands to the epicardial satellite device. The epicardial satellite pacemaker is a leadless device mounted directly on the epicardium of the left ventricle. The epicardial pacemaker can be implanted using a thoracoscopic procedure during implant of the master unit. In special events, it can be implanted using prophylactic techniques during heart bypass surgery of other surgical procedures where access to the heart is available. Much work needs to be done to prove the technology. But current RF communication capabilities in today’s devices offer the groundbreaking path to develop a satellite LV pacing design.