An Implantable Sensorized Lead for Continuous Monitoring of Cardiac Apex Rotation.

Emanuela Marcelli,Laura Cercenelli

doi:10.3390/s18124195

Emanuela Marcelli, Laura Cercenelli

Open Access

https://doi.org/10.3390/s18124195

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Abstract

Changes in the pattern or amplitude of cardiac rotation have been associated with important cardiovascular diseases, including Heart Failure (HF) which is one of the major health problems worldwide. Recent advances in echocardiographic techniques have allowed for non-invasive quantification of cardiac rotation; however, these examinations do not address the continuous monitoring of patient status. We have presented a newly developed implantable, transvenous lead with a tri-axis (3D) MEMS gyroscope incorporated near its tip to measure cardiac apex rotation in the three-dimensional space. We have named it CardioMon for its intended use for cardiac monitoring. If compared with currently proposed implantable systems for HF monitoring based on the use of pressure sensors that can have reliability issues, an implantable motion sensor like a gyroscope holds the premise for more reliable long term monitoring. The first prototypal assembly of the CardioMon lead has been tested to assess the reliability of the 3D gyroscope readings. In vitro results showed that the novel sensorized CardioMon lead was accurate and reliable in detecting angular velocities within the range of cardiac twisting velocities. Animal experiments will be planned to further evaluate the CardioMon lead in in vivo environments and to investigate possible endocardial implantation sites.

Highlights

Cardiac torsion is the wringing motion of the heart around its long axis created by oppositely directed apical and basal rotations and is determined by contracting myofibers, which are arranged in opposite directions between the subendocardial and subepicardial layers [1]
This motion is essential for regulating cardiac systolic and diastolic functions and changes in the pattern or amplitude of cardiac rotation have been associated with various cardiovascular diseases, such as hypertrophic or dilated cardiomyopathy, aortic stenosis, myocardium ischemia, acute myocardial infarction, and Heart
We present the CardioMon, a novel, implantable, sensorized lead equipped with a tri-axis MEMS gyro sensor (3D gyro), intended to continuously monitor cardiac rotation both at epicardial and endocardial sites

Summary

Introduction

Cardiac torsion is the wringing motion of the heart around its long axis created by oppositely directed apical and basal rotations and is determined by contracting myofibers, which are arranged in opposite directions between the subendocardial and subepicardial layers [1]. The availability of advanced non-invasive imaging techniques such as tagged magnetic resonance imaging, Doppler tissue imaging, and speckle tracking imaging have expanded the understanding of the relationships between cardiac rotation and cardiac diseases. Such noninvasive examinations can be used only on an intermittent basis and are not intended to continuously monitor cardiac rotation. Other PAP measurement systems are being developed, including a small, implanted sensor that has a battery in the capsule

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