Key result
Modified Utah Electrode Arrays demonstrated strong charge-transfer performance and high selectivity in sensing the His-Bundle at short pacing durations with current levels up to 4 mA.
Why the study?
Utah Electrode Arrays had previously been used for neural applications at low currents, but their applicability for sub-surface cardiac sensing and His-bundle pacing had not been investigated.
Modified Utah Electrode Arrays demonstrate proof-of-concept feasibility for selective sub-surface sensing and pacing of the His-Bundle in an ex vivo goat heart model, though electrode delamination occurs at higher currents and longer durations.
Feasibility shown for selective His-bundle sensing with modified arrays; hypothesis-generating in animal models and requires in vivo validation.
Utah Electrode Arrays (UEAs) have previously been characterized and implanted for neural recordings and stimulation at relatively low current levels. This proof-of-concept study investigated the applicability of UEAs in sub-surface cardiac pacing, for the first time, particularly to selectively sense and pace the His-Bundle (HB). HB pacing produces synchronous ventricular depolarization and improved cardiac function. Modified UEAs with sputtered iridium oxide film (SIROF) tips (100 - 150 μm) were characterized for SIROF delamination using an electrochemical impedance spectroscopy (EIS), scanning electron microscopy (SEM), and voltage transient (VT) techniques at various current levels of up to 8 mA for a biphasic pulse with 1 ms duration per phase at 4 Hz. Our results indicate that at a short pacing duration of 20 s with current levels of up to 4 mA, the SIROF exhibited a strong charge-transfer performance. For the longer pacing duration (6 min), SIROF demonstrated its holding capacity at all current levels except for ≥2 mA when delamination commenced for the time exceeded 4 min (EIS) and 2 min (VT). UEAs were inserted in isolated, perfused goat hearts to record the HB electrograms in real-time. Both stimulated and unstimulated electrodes were characterized for SIROF delamination before, during and after in vivo work. Our findings indicate that UEA was stable during the heart's contraction and relaxation phase. Further, at a short pacing duration with current levels of up to 4 mA, UEA demonstrated high selectively in sensing the HB. This proof-of-concept work demonstrates the potential applicability of UEAs in cardiac applications.
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Shah et al. (2020) studied Sub-surface cardiac His-Bundle pacing. Modified Utah Electrode Arrays (UEAs) with sputtered iridium oxide film (SIROF) tips was evaluated on SIROF delamination, charge-transfer performance, and His-Bundle sensing selectivity. Modified Utah Electrode Arrays demonstrated strong charge-transfer performance and high selectivity in sensing the His-Bundle at short pacing durations with current levels up to 4 mA.
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