Electromechanical cardioplasty using a wrapped elasto-conductive epicardial mesh

Jinkyung Park, Suji Choi, Ajit H. Janardhan, Se Yeon Lee, Samarth Raut, Joao Soares, Kwangsoo Shin, Shixuan Yang, Chungkeun Lee, Ki Woon Kang, Hye Rim Cho, Seok Joo Kim, Pilseon Seo, Wonji Hyun, Sungmook Jung, Hye Jeong Lee, Nohyun Lee, Seung Hong Choi, Michael Sacks, Nanshu LuMark E. Josephson, Taeghwan Hyeon, Dae Hyeong Kim, Hye Jin Hwang

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Heart failure remains a major public health concern with a 5-year mortality rate higher than that of most cancers. Myocardial disease in heart failure is frequently accompanied by impairment of the specialized electrical conduction system and myocardium. We introduce an epicardial mesh made of electrically conductive and mechanically elastic material, to resemble the innate cardiac tissue and confer cardiac conduction system function, to enable electromechanical cardioplasty. Our epicardium-like substrate mechanically integrated with the heart and acted as a structural element of cardiac chambers. The epicardial device was designed with elastic properties nearly identical to the epicardial tissue itself and was able to detect electrical signals reliably on the moving rat heart without impeding diastolic function 8 weeks after induced myocardial infarction. Synchronized electrical stimulation over the ventricles by the epicardial mesh with the high conductivity of 11,210 S/cm shortened total ventricular activation time, reduced inherent wall stress, and improved several measures of systolic function including increases of 51% in fractional shortening, ∼90% in radial strain, and 42% in contractility. The epicardial mesh was also capable of delivering an electrical shock to terminate a ventricular tachyarrhythmia in rodents. Electromechanical cardioplasty using an epicardial mesh is a new pathway toward reconstruction of the cardiac tissue and its specialized functions.

Original languageEnglish
Article number344ra86
JournalScience Translational Medicine
Volume8
Issue number344
DOIs
StatePublished - 22 Jun 2016

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Heart Failure
Pericardium
Cardiomyopathies
Tachycardia
Electric Stimulation
Rodentia
Shock
Myocardium
Public Health
Myocardial Infarction
Equipment and Supplies
Mortality
Neoplasms

Cite this

Park, J., Choi, S., Janardhan, A. H., Lee, S. Y., Raut, S., Soares, J., ... Hwang, H. J. (2016). Electromechanical cardioplasty using a wrapped elasto-conductive epicardial mesh. Science Translational Medicine, 8(344), [344ra86]. https://doi.org/10.1126/scitranslmed.aad8568
Park, Jinkyung ; Choi, Suji ; Janardhan, Ajit H. ; Lee, Se Yeon ; Raut, Samarth ; Soares, Joao ; Shin, Kwangsoo ; Yang, Shixuan ; Lee, Chungkeun ; Kang, Ki Woon ; Cho, Hye Rim ; Kim, Seok Joo ; Seo, Pilseon ; Hyun, Wonji ; Jung, Sungmook ; Lee, Hye Jeong ; Lee, Nohyun ; Choi, Seung Hong ; Sacks, Michael ; Lu, Nanshu ; Josephson, Mark E. ; Hyeon, Taeghwan ; Kim, Dae Hyeong ; Hwang, Hye Jin. / Electromechanical cardioplasty using a wrapped elasto-conductive epicardial mesh. In: Science Translational Medicine. 2016 ; Vol. 8, No. 344.
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Park, J, Choi, S, Janardhan, AH, Lee, SY, Raut, S, Soares, J, Shin, K, Yang, S, Lee, C, Kang, KW, Cho, HR, Kim, SJ, Seo, P, Hyun, W, Jung, S, Lee, HJ, Lee, N, Choi, SH, Sacks, M, Lu, N, Josephson, ME, Hyeon, T, Kim, DH & Hwang, HJ 2016, 'Electromechanical cardioplasty using a wrapped elasto-conductive epicardial mesh', Science Translational Medicine, vol. 8, no. 344, 344ra86. https://doi.org/10.1126/scitranslmed.aad8568

Electromechanical cardioplasty using a wrapped elasto-conductive epicardial mesh. / Park, Jinkyung; Choi, Suji; Janardhan, Ajit H.; Lee, Se Yeon; Raut, Samarth; Soares, Joao; Shin, Kwangsoo; Yang, Shixuan; Lee, Chungkeun; Kang, Ki Woon; Cho, Hye Rim; Kim, Seok Joo; Seo, Pilseon; Hyun, Wonji; Jung, Sungmook; Lee, Hye Jeong; Lee, Nohyun; Choi, Seung Hong; Sacks, Michael; Lu, Nanshu; Josephson, Mark E.; Hyeon, Taeghwan; Kim, Dae Hyeong; Hwang, Hye Jin.

In: Science Translational Medicine, Vol. 8, No. 344, 344ra86, 22.06.2016.

Research output: Contribution to journalArticle

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AU - Choi, Suji

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AU - Lee, Se Yeon

AU - Raut, Samarth

AU - Soares, Joao

AU - Shin, Kwangsoo

AU - Yang, Shixuan

AU - Lee, Chungkeun

AU - Kang, Ki Woon

AU - Cho, Hye Rim

AU - Kim, Seok Joo

AU - Seo, Pilseon

AU - Hyun, Wonji

AU - Jung, Sungmook

AU - Lee, Hye Jeong

AU - Lee, Nohyun

AU - Choi, Seung Hong

AU - Sacks, Michael

AU - Lu, Nanshu

AU - Josephson, Mark E.

AU - Hyeon, Taeghwan

AU - Kim, Dae Hyeong

AU - Hwang, Hye Jin

PY - 2016/6/22

Y1 - 2016/6/22

N2 - Heart failure remains a major public health concern with a 5-year mortality rate higher than that of most cancers. Myocardial disease in heart failure is frequently accompanied by impairment of the specialized electrical conduction system and myocardium. We introduce an epicardial mesh made of electrically conductive and mechanically elastic material, to resemble the innate cardiac tissue and confer cardiac conduction system function, to enable electromechanical cardioplasty. Our epicardium-like substrate mechanically integrated with the heart and acted as a structural element of cardiac chambers. The epicardial device was designed with elastic properties nearly identical to the epicardial tissue itself and was able to detect electrical signals reliably on the moving rat heart without impeding diastolic function 8 weeks after induced myocardial infarction. Synchronized electrical stimulation over the ventricles by the epicardial mesh with the high conductivity of 11,210 S/cm shortened total ventricular activation time, reduced inherent wall stress, and improved several measures of systolic function including increases of 51% in fractional shortening, ∼90% in radial strain, and 42% in contractility. The epicardial mesh was also capable of delivering an electrical shock to terminate a ventricular tachyarrhythmia in rodents. Electromechanical cardioplasty using an epicardial mesh is a new pathway toward reconstruction of the cardiac tissue and its specialized functions.

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