Ventricular arrhythmias including ventricular tachycardia (VT) and ventricular fibrillation (VF) are responsible for 300,000 sudden cardiac deaths a year in the US. Electrotherapy has been effective in arresting VT/VF but the high-energy biphasic shocks can lead to myocardial damage and associated co-morbidities. Moreover the implantable cardioverter defibrillator technology (ICD) has low VT/VF sensing resolution, which can lead to inappropriate shocks and associated psychological distress, resulting in diminished quality of life or even death. Thus, there is an unmet need for high-definition VT/VF sensing to reduce inappropriate shocks and similarly, an unmet need for high-definition ultra-low energy electrotherapy to terminate VT/VF. In this project, we present a novel approach to VT/VF sensing and electrotherapy and redesign the ICD into cardiovascular implantable electronic device (CIED). We will employ two break-through technological platforms to implement our novel method: (1) A novel conformal chiplet electronics real-time networks (CCERN) technology developed by Co-Investigator Dr. Rogers and an (2) innovative panoramic, transillumination optical mapping developed by PI Dr. Efimov. We will conduct high-definition, panoramic, transillumination, optical mapping in conjunction with high-definition CCERN to (1) characterize the transmural VT/VF dynamics, (2) determine the optimal number of sensors needed to dynamically track the excitable gaps, phase singularities, and wavefronts during VT/VF, and (3) terminate VT/VF using optimal definition ultra low-energy high-definition electrotherapy. This proposed work would advance our understanding of VT/VF and pave the path towards creating a targeted individualized therapy dynamically tailored for each arrhythmia episode for each patient.
Ventricular fibrillation (rapid and irregular heart beat) is responsible for 300,000 sudden cardiac deaths (SCD) annually in the United States. SCD is a massive burden on the US economics and the healthcare system. Current treatment options have limited efficacy and are hampered by serious side effects. Future development of an effective therapy requires detailed knowledge of the disorganized electrical waves in the fibrillating human ventricles. This project will apply novel organ conformal chiplet electronics real-time networks (CCERN) technology to track the development and propagation of these rapid, disorganized electrical waves and terminate them with high precision and minimized side effects, thereby creating a targeted individualized therapy dynamically tailored for each arrhythmia episode for each patient.
