Right ventricular outflow tract (RVOT) is a common source of idiopathic ventricular arrhythmias (IVAs).
However, the mechanisms underlying the RVOT’s unique arrhythmia susceptibility remains not well elucidated due to lack of detailed electrophysiological and molecular studies of human RVOT.
WHAT THE STUDY ADDS
Human RVOT electrophysiology is characterized by shorter APD relative to the right ventricular apical region and drives the transmural dispersion of repolarization and transmural APD dispersion under normal physiological conditions.
Cholinergic stimulation attenuates the arrhythmogenic effects of adrenergic stimulation, including increase in frequency of PVCs and shortening of wavelength.
Arrhythmia in the RV is associated with weak positive spatiotemporal autocorrelation between the epicardial-endocardial arrhythmic wavefronts and reentrant rotors that are relatively more organized in the endocardium.
Flexible electronic/optoelectronic systems that can physically interface with soft biological tissue surfaces offer revolutionary diagnostic and therapeutic capabilities for various diseases.
However, current approaches to coupling the tissue-device interfaces either through surgical sutures, staples, cuffs, etc., damage the tissue and the devices and often result in adverse immune responses and mechanical instabilities.
WHAT DOES THIS STUDY ADD?
We introduce a functional adhesive bioelectronic-tissue interface material (BTIM), which is mechanically compliant, electrically conductive, and optically transparent. The material can bond to the surface of tissue and the device and provide stable adhesion for several days to months.
We demonstrate the capabilities of this material in live animal models that includes device applications ranging from battery-free optoelectronic systems for deep-brain optogenetics to wireless millimeter-scale pacemakers and flexible multi electrode epicardial arrays.
Defibrillation remains the only effective therapy against sudden cardiac death. However, the current coil-based lead ICD devices are limited by high defibrillation threshold (DFT) and low arrhythmia sensing resolution, which can result in inappropriate and painful shocks adversely affecting the quality of life. Emerging classes of materials and mechanics concepts in the field of flexible and stretchable electronics have created new opportunities for integrating high-performance electronics with the human body and its organs and various tissues. These conformal electronics devices offer a platform for high-definition arrhythmia sensing to minimize inappropriate shocks and improve therapy and high-definition therapy delivery circuit to reduce DFT.