New heart implants monitor, treat and then dissolve

By Dennis Thompson Health Day Reporter

FRIDAY, July 7, 2023 (HealthDay News) — An experimental implant currently in development could serve as a temporary monitor and pacemaker for sick heart patients — then dissolve when no longer needed.

The soft, lightweight, transparent implant is about the size of a postage stamp and is made of biodegradable polymers and metals, the researchers reported July 5 in the journal. Scientists progress.

Early experiments have shown that the implant can be placed on a lab rat’s heart, take precise measurements, and then safely dissolve and be absorbed.

The implant would be a boon for patients who have developed heart rhythm complications following a heart attack, surgery or other treatment, the co-lead researcher said. Igor Yefimovexperimental cardiologist and professor of biomedical engineering at Northwestern University in Chicago.

Those patients now have to wear sticky sensors and carry a bulky monitor so doctors can track their heart as it recovers, Efimov said.

“The challenge with these devices is that they’re not very comfortable,” he said. “They interfere with daily functioning. For example, you cannot wash yourself in the shower very easily.

The new implant could be inserted during surgery or heart surgery. It would provide data through electrodes and optical sensors, and could even be configured to deliver an electric jolt to correct any irregular heartbeats that occur, Efimov said.

“Let’s say someone has just had heart surgery. After heart surgery, approximately 30% of patients will develop atrial fibrillation [a-fib],” he said. “We want to create an electronic device that can be implanted for as long as it takes and then dissolve.”

In the event of postoperative complications such as a-fib, the devices would typically be needed for about 10 days and then not be needed, Efimov said.

About a third of the nearly 700,000 people who die each year from heart disease in the United States succumb to complications within the first few weeks or months following a heart attack or heart surgery, the researchers noted.

“Many of the deaths that occur following heart surgery or heart attack could be prevented if doctors had better tools to monitor and treat patients in the delicate weeks and months following these events,” said the co-principal investigator. Luyao Luassistant professor of biomedical engineering at George Washington University in Washington, D.C.

The device is made entirely of materials that have been deemed safe and biocompatible for humans by the U.S. Food and Drug Administration, Lu said.

For example, the electrodes are made mostly of molybdenum, an element that occurs naturally in the human body, Lu said. The transparent, flexible frame of the device is made of poly(lactic-co-glycolic acid), or PLGA. , a polymer that naturally degrades into harmless chemicals.

“They are all safe and have been approved by the FDA for human use,” Lu said.

The researchers compare the implant to absorbable stitches that break down and then disappear as the body absorbs them. Patients would not have to undergo follow-up surgeries to remove or adjust an implant.

The researchers designed the implant to be flexible, so it could be easily placed without causing discomfort, Efimov said.

They also made it mostly from transparent materials so that the implant’s optical sensors could provide readings of oxygen levels, metabolism and other important metrics, he added.

Currently, many heart patients end up with a permanent pacemaker when they may not really need it, said Dr Deepak Bhattdirector of Mount Sinai Heart in New York.

Others are forced to spend longer periods in a hospital with a temporary pacemaker and then undergo another surgery to have it removed, said Bhatt, who was not involved in the new study.

The experimental implant “could be a really helpful solution, either helping a patient get out of the hospital sooner instead of having a temporary pacemaker that ties them to the hospital for several days, or giving them a permanent pacemaker but then having to deal with that for the rest of their lives,” Bhatt said.

Bhatt gave the example of a person undergoing a heart valve replacement.

“A certain percentage of these patients, maybe 5-10%, will end up needing a pacemaker because their heart rate slows as a result of the procedure,” he said. “Potentially with this technology here, which as far as experiments show is fully bioabsorbable, one could envision there being some sort of temporary pacemaker that dissolves in the next few weeks when the native pacemaker function of the heart resumes.”

Instead of ending up with a permanent implant, as is currently the case, Bhatt said a patient would receive an implant that eventually dissolves.

“To be clear, this is very early research, but the experiments they did, I thought were carefully designed, quite elegant, and showed that these microelectrode arrays could potentially be useful in situations specific clinics,” Bhatt said.

The device is still years away from being available to humans, Efimov said.

Efforts are underway to add wireless data transmission to the implant, he said. It then needs to be tested in larger animals with human-like heart systems, most likely pigs, before it’s ready for human trials.

“We have a few apps that I think realistically can probably deliver something in three to five years, on relatively simple devices like this,” Efimov said. “More sophisticated devices may take longer.”

Once the implant technology is perfected, Efimov can consider using it to treat many other types of diseases.

For example, temporary implants could track diseases of the brain, gut and lungs, he said.

“There are so many potential applications, once the technology has been developed,” Efimov said. “You just applied it to different areas of medicine.”

SOURCES: Igor Efimov, PhD, professor, biomedical engineering, Northwestern University, Chicago; Luyao Lu, PhD, assistant professor, biomedical engineering, George Washington University, Washington, DC; Deepak Bhatt, MD, MPH, director, Mount Sinai Heart, New York; Scientists progressJuly 5, 2023

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