Three-Dimensional Printed Biopatches With Conductive Ink Facilitate Cardiac Conduction When Applied to Disrupted Myocardium
Journal article, 2019
BACKGROUND: Reentrant ventricular arrhythmias are a major cause of sudden death in patients with structural heart disease. Current treatments focus on electrically homogenizing regions of scar contributing to ventricular arrhythmia with ablation or altering conductive properties using antiarrhythmic drugs. The high conductivity of carbon nanotubes may allow restoration of conduction in regions where impaired electrical conduction results in functional abnormalities. We propose a new concept for arrhythmia treatment using a stretchable, flexible biopatch with conductive properties to attempt to restore conduction across regions in which activation is disrupted.
METHODS: Carbon nanotube patches composed of nanofibrillated cellulose/single-walled carbon nanotube ink 3-dimensionally printed in conductive patterns onto bacterial nanocellulose were developed and evaluated for conductivity, flexibility, and mechanical properties. The patches were applied on 6 canines to epicardium before and after surgical disruption. Electroanatomic mapping was performed on normal epicardium, then repeated over surgically disrupted epicardium, and then finally with the patch applied passively.
RESULTS: We developed a 3-dimensional printable carbon nanotube ink complexed on bacterial nanocellulose that was (1) expressable through 3-dimensional printer nozzles, (2) electrically conductive, (3) flexible, and (4) stretchable. Six canines underwent thoracotomy, and, during epicardial ventricular pacing, mapping was performed. We demonstrated disruption of conduction after surgical incision in all 6 canines based on activation mapping. The patch resulted in restored conduction based on mapping and assessment of conduction direction and velocities in all canines.
CONCLUSIONS: We have demonstrated 3-dimensional custom-printed electrically conductive carbon nanotube patches can be surgically manipulated to improve cardiac conduction when passively applied to surgically disrupted epicardial myocardium in canines.
ink
electrophysiology
mapping
nanotubes, carbon
Author
Dawn M. Pedrotty
University of Pennsylvania
Mayo Clinic
Volodymyr Kuzmenko
Chalmers, Microtechnology and Nanoscience (MC2), Electronics Material and Systems
Wallenberg Wood Science Center (WWSC)
Erdem Karabulut
Chalmers, Chemistry and Chemical Engineering, Applied Chemistry
Wallenberg Wood Science Center (WWSC)
Alan M. Sugrue
Mayo Clinic
Christopher Livia
Mayo Clinic
Vaibhav R. Vaidya
Mayo Clinic
Christopher J. McLeod
Mayo Clinic
Samuel J. Asirvatham
Mayo Clinic
Paul Gatenholm
Chalmers, Chemistry and Chemical Engineering, Applied Chemistry
Wallenberg Wood Science Center (WWSC)
Suraj Kapa
Mayo Clinic
Circulation: Arrhythmia and Electrophysiology
1941-3149 (ISSN) 1941-3084 (eISSN)
Vol. 12 3 e006920Subject Categories
Textile, Rubber and Polymeric Materials
Biomedical Laboratory Science/Technology
Composite Science and Engineering
DOI
10.1161/CIRCEP.118.006920
PubMed
30845835