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The monolithic fetal pacemaker: prototype lead design for closed thorax deployment.

Joseph Dell'Orfano·Howard A Chou·Daegyun Park·Humair Mirza·Tomasz Stys·Vicki Mahan·Daniel H Zavitz·Boris M Petrikovsky·Marc Ovadia
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Abstract

Prenatal sudden cardiac death and hydrops fetalis are often due to complete heart block. However, no pacing modality exists for intrauterine application for fetal bradycardia. A prototype lead for a novel fetal pacemaker has been developed and used in a direct pacing model. It has been demonstrated that the lead can be safely and successfully deployed using a hypochondriac and transdiaphragmatic or subxiphoid approach. Pacing with ventricular capture was evident with the widening of QRS duration from 50.2 +/- 9.8 to 95.1 +/- 12.8 ms (P = 0.0001). Further studies by echocardiogram revealed an increase in the pulse with pacing, confirming pacing. This study documents proof-of-concept for closed thorax over-the-wire deployment of a novel lead design applicable to fetal pacing. By combining the lead design with microcircuitry and a small power source, it is possible to create a monolithic fetal pacemaker system capable of being deployed in utero.

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AnimalsCardiac Pacing, ArtificialEchocardiographyElectrocardiographyEquipment DesignHeart BlockHydrops FetalisPacemaker, ArtificialPrenatal CareRatsRats, Sprague-DawleyJournal ArticleResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.

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Joseph Dell'Orfano, Howard A Chou, Daegyun Park, Humair Mirza, Tomasz Stys, Vicki Mahan, Daniel H Zavitz, Boris M Petrikovsky, Marc Ovadia. 2003. The monolithic fetal pacemaker: prototype lead design for closed thorax deployment.. https://doi.org/10.1046/j.1460-9592.2003.t01-1-00143.x

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