Ventricular arrhythmias are the leading cause of sudden cardiac death and originate from scarred cardiac tissue. The smaller veins and tributaries that cross over the ventricle can be used to restore conduction across the tissue. However, current pacing leads are not able to access those vessels. We propose a new paradigm for restoring conduction through the diseased myocardium by using in-situ curing conductive hydrogels as pacemaker lead extensions. In this new approach, hydrogel precursor solutions are injected into coronary veins and connected to a pacemaker to provide a new conductive pathway. The conductive hydrogel was synthesized by incorporating metallic nanoparticles into a polyethylene glycol based hydrogel. The in-situ cure rates of the hydrogel solutions were controlled with redox-initiated crosslinking. By varying concentrations of ammonium persulfate and iron gluconate, we demonstrated cure times of less than 2 minutes at concentrations that have shown high cell viability. The nanoparticles concentration inside the network was varied and its impact on conductivity was determined. The hydrogel precursor solutions were injected using a dual lumen catheter (Figure 1A) into the anterior interventricular vein (AIV) epicardially in an acute porcine model. X-ray was used to confirm delivery and retention in the AIV. Successful filling of the AIV and small tributaries with the conductive hydrogel was confirmed with contrast under x-ray. Gross examination of the excised hydrogel (Figure 1B) indicated rapid gelation following catheter delivery. Temporary pacing wires were used to provide pacing to the heart via the hydrogel. Myocardial capture was confirmed in ECG upon pacing at 120 BPM with 2mA (Figure 1C). This conductive hydrogel with rapid in situ cure shows promise as a platform technology to expand the pacing capabilities of current technology. Future studies will evaluate the extent of capture in vivo and optimize hydrogel properties for long-term pacing applications.

Conductive hydrogels with rapid <i>in situ</i> cure to improve cardiac pacing

Macromolecular Chemistry: The Second Century

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ACS Spring 2020 National Meeting & Expo

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Conductive hydrogels with rapid in situ cure to improve cardiac pacing