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Boston Scientific CRT Research

Boston Scientific CRT Research. Dr. Knisley Frank Giammo Amanda Schaeffer John Spain. Assist Dr. Knisley in pilot experiment for Boston Scientific. Focus: Cardiac Resynchronization Therapy(CRT) methods. Objective.

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Boston Scientific CRT Research

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  1. Boston Scientific CRT Research Dr. Knisley Frank Giammo Amanda Schaeffer John Spain

  2. Assist Dr. Knisley in pilot experiment for Boston Scientific. • Focus: Cardiac Resynchronization Therapy(CRT) methods Objective

  3. Heart Failure: the inablity of the heart to supply the body with sufficient blood flow. • Common Causes: • Myocardial infarction: Heart attack • Heart Disease: • Ischemic: Reduced blood supply to myocardium • Valvular: Any disease process which involves the valves • Cardiomyopathy: Deterioration of the myocardium's functionality. • Hypertension: High blood pressure Affects ~2% of adults in developed countries, and 6-10% ages 65+ Leading cause of death in United states (25% of total deaths) Heart Failure

  4. Transplant: Most severe method; reserved for mainly end-stage heart failure or severe coronary artery disease patients. • Pharmaceutical: Use of drugs to treat specific types of heart disease. Common medications: Aspirin, Beta-Blockers, ACE inhibitor, Blood Cholesterol-lowering Agents. • Cardiac Resynchronization Therapy(CRT): Electrical pacing of the heart by electrodes in order to regulate the heart’s rhythm e.g. pacemaker. Heart Disease Therapies

  5. Can be programmed per patient, and controlled externally. • Allows for continuous real-time monitoring of heart. • Can be implanted in body and also coupled with a defibrillator, which allows for immediate response to heart failure. • Three types of CRT: • Unipolar • Bipolar • OverLapping Biphasic(OLBI) Cardiac Resynchronization Therapy

  6. note: All circuit models are derived from Lazarus’ models Unipolar Bipolar OLBI + Circuit & Physical Models + + _ _ _ Note: Both OLBI and bipolar use two wires

  7. Main Goal: Determine whether OLBI pacing affects the heart differently than bipolar methods. • Minor Goals: Locate His bundle, refine protocol for optical mapping, and verify OLBI model defined by Lazarus. Research Outline & Goals

  8. Eleven experiments were conducted in groups of two in between May and August • Each experiment’s objective was unique: • Pacing thresholds • Optical recording of different modes of pacing with use of fluorescent dye(DYE-4 ANEPPS) • Stimulation Duration • Locating His bundle • Intermediate results from previous experiments guided future interests • Road blocks encountered: High background noise in both Powerlab and optical data, His bundle stimulation, application of data, synchronization of equipment for optical data Summer Experiments

  9. Top-view of Experimental Area

  10. Recently Extracted Heart

  11. Problem: Cyclical noise interfering with His signal detection in Powerlab data. • Solution: Apply a learning filter which would remove noise without skewing real values due to interpolation. Learning Filter

  12. Learning Filter Example

  13. Primary Goal: Verify OLBI model. • Create ammeter to measure current with respect to position of electrodes • Test experimental procedure with saline model • Decide whether to proceed to live experiment • Analyze summer data and submit conclusions Now + _

  14. Gantt Chart

  15. Lazarus, A. “Reduction in Energy Pacing Thresholds by Overlapping Biphasic Stimulation Versus Conventional Bipolar Pacing.” Saint Cloud, France. 2006 • Common Heart Disease Medications. http://www.caregiverslibrary.org/Default.aspx?tabid=473 • Heart Disease. http://en.wikipedia.org/wiki/Heart_disease. • http://en.wikipedia.org/wiki/File:Idiopathic_cardiomyopathy,_gross_pathology_20G0018_lores.jpg (ref figure on slide Heart Disease Therapies) • Drawings by Frank Giammo • Photos, lab figures c/o Dr. Knisley References

  16. Questions????

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