Temporary postoperative cardiac pacing requires devices with percutaneous leads and external wired power and control systems. This hardware introduces risks for infection, limitations on patient mobility, and requirements for surgical extraction procedures. Bioresorbable pacemakers mitigate some of these disadvantages, but they demand pairing with external, wired systems and secondary mechanisms for control. We present a transient closed-loop system that combines a time-synchronized, wireless network of skin-integrated devices with an advanced bioresorbable pacemaker to control cardiac rhythms, track cardiopulmonary status, provide multihaptic feedback, and enable transient operation with minimal patient burden. The result provides a range of autonomous, rate-adaptive cardiac pacing capabilities, as demonstrated in rat, canine, and human heart studies. This work establishes an engineering framework for closed-loop temporary electrotherapy using wirelessly linked, body-integrated bioelectronic devices.
Bibliographical noteFunding Information:
This work was funded by National Institutes of Health grants 1K99HL155844-01A1 (Y.S.C.), R01-HL141470 (I.R.E. and J.A.R.), R01 HL140061 (R.K.A.), R01 HL125881 (R.K.A.), KL2TR001424 (A.P.), F30HL157066 (A.T.), and 5K99-HL148523-02 (K.A.); Ministry of Health & Welfare, Republic of Korea (Korea Health Industry Development Institute), grant HI19C1348 (Y.S.C. and H.-Y.A.); Leducq Foundation project RHYTHM (I.R.E. and J.A.R.); American Heart Association 18SFRN34110170 (R.K.A.); American Heart Association Predoctoral Fellowship 19PRE34380781 (R.T.Y.); National Science Foundation Graduate Research Fellowship 1842165 (R.A.); a Ford Foundation Predoctoral Fellowship (R.A.); Chan Zuckerberg Initiative DAF grant 2020-225578 (E.A.W.); and an advised fund of the Silicon Valley Community Foundation (E A W)
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