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Injectable conductive hydrogel restores conduction through ablated myocardium
  • +10
  • Martin van Zyl,
  • Dawn Pedrotty,
  • Erdem Karabalut,
  • Volodymyr Kuzmenko,
  • Sanna Sämfors,
  • Chris Livia,
  • Vaibhav Vaidya,
  • Alan Sugrue,
  • Christopher McLeod,
  • Atta Behfar,
  • Samuel Asirvatham,
  • Paul Gatenholm,
  • Suraj Kapa
Martin van Zyl
Mayo Clinic
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Dawn Pedrotty
Hospital of the University of Pennsylvania
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Erdem Karabalut
Chalmers University of Technology
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Volodymyr Kuzmenko
Chalmers University of Technology
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Sanna Sämfors
Chalmers University of Technology
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Chris Livia
Mayo Clinic Rochester
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Vaibhav Vaidya
Mayo Clinic
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Alan Sugrue
Mayo Clinic Rochester
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Christopher McLeod
Mayo Clinic
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Atta Behfar
Mayo Clinic Rochester
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Samuel Asirvatham
Mayo Clinic
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Paul Gatenholm
Chalmers University of Technology
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Suraj Kapa
Mayo Clinic
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Peer review status:IN REVISION

28 Jun 2020Submitted to Journal of Cardiovascular Electrophysiology
29 Jun 2020Assigned to Editor
29 Jun 2020Submission Checks Completed
29 Jun 2020Reviewer(s) Assigned
14 Jul 2020Review(s) Completed, Editorial Evaluation Pending
16 Jul 2020Editorial Decision: Revise Minor

Abstract

Abstract Introduction: Therapies for substrate-related arrhythmias include ablation or drugs targeted at altering conductive properties or disruption of slow zones in heterogeneous myocardium. Conductive compounds such as carbon nanotubes may provide a novel personalizable therapy for arrhythmia treatment by allowing tissue homogenization. Methods: A nanocellulose-carbon nanotube conductive hydrogel was developed to have conduction properties similar to normal myocardium. Ex vivo perfused canine hearts were studied. Electroanatomic activation mapping of the epicardial surface was performed at baseline, after radiofrequency ablation, and after uniform needle injections of the conductive hydrogel through the injured tissue. Gross histology was used to assess distribution of conductive hydrogel in the tissue. Results: The conductive hydrogel viscosity was optimized to decrease with increasing shear rate to allow expression through a syringe. The DC conductivity under aqueous conduction was 4.3·10-1 S/cm. In 4 canine hearts, when compared to the homogeneous baseline conduction, isochronal maps demonstrated sequential myocardial activation with a shift in direction of activation to surround the edges of the ablated region. After injection of conductive hydrogel, isochrones demonstrated conduction through the ablated tissue with activation similar to baseline in all 4 hearts. Gross specimen examination demonstrated retention of the hydrogel within the tissue. Conclusions: This proof-of-concept study demonstrates that conductive hydrogel can be injected into acutely disrupted myocardium to restore conduction. Future experiments should focus on evaluating long-term retention and biocompatibility of the hydrogel through in vivo experimentation.