Abstract
In cardiac pacemaker design, energy expenditure is an important issue. This work aims to explore whether varying stimulation pulse configuration is a viable optimization strategy for reducing energy consumption by the pacemaker. A single cardiomyocyte was used as an experimental model. Each cardiomyocyte was stimulated with different stimulation protocols using rectangular waveforms applied in varying number, in short succession. The amplitude, the width of each pulse, and the interval between consecutive pulses were modified. The application of multiple pulses in a short sequence led to a reduction of the threshold voltage required for stimulation when compared to a single pulse. However, none of the employed multi-pulse sequences reduced the overall energy expenditure of cell stimulation when compared to a single pulse stimulation. Among multiple pulse protocols, a combination of two short pulses (1 ms) separated with a short interval (0.5 ms) had the same energy requirements as a single short pulse (1 ms), but required the application of significantly less voltage. While increasing the number of consecutive pulses does not reduce the energy requirements of the pacemaker, the reduction in threshold voltage can be considered in practice if lower stimulation voltages are desired.
Highlights
State-of-the-art pacemakers, including presently available leadless pacemakers, use electrodes with relatively large surface areas
The main result of our study is that electrical stimulation with multiple rectangular pulses does not lead to energy savings in cardiomyocyte stimulation
When analyzing the obtained threshold voltages and energy expenditure, it is critical to consider that the experiments were performed on single cardiomyocytes
Summary
State-of-the-art pacemakers, including presently available leadless pacemakers, use electrodes with relatively large surface areas (diameter 6 mm). This has a direct impact on the voltage threshold and pulse duration required for reliable pacing, and the energy consumption of the device[3,4]. Smaller areas of the myocardium are expected to be targeted by future pacemakers, as emerging technologies enable the design and fabrication of nano-scale electrodes[8] While such modifications may increase the efficiency of pacing, there are other trends in the industry that may limit battery capacity. The aim of this study is to evaluate energy efficiency and threshold voltages of single- and multiple-pulse stimulation sequences for actuation of the heart. By following intracellular calcium concentration changes we were able to determine the success of each stimulation protocol and relate it to the energy employed for stimulation
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