Poster U8 - Smart TAVI/TAVR Device Capable of Heart Rhythm Pacing & Resynchronization

Introduction: Transaortic valve implantation/replacement (TAVI/TAVR) procedure has become one of the most rapidly evolving procedures with ever-expanding indications: from critical aortic stenosis 10 years ago to mild stenosis nowadays. However, around 30% of the patients undergoing TAVI/TAVR procedure develop heart rhythm abnormalities, requiring implantation of a temporary pacemaker. There us an unmet need for the TAVI/TAVR valve to be able to provide pacing and resynchronization of heart rhythm in the post-operative period.

Materials and

Methods: Donor human heart, which was declined for transplantation, was put on the Langendorff perfusion system and perfused with Tyrode's solution until it regained spontaneous heart rhythm and contractions. Millimeter-Scale Near-Infrared (NIR) Activated pacemakers were integrated on the Nitinol frame resembling the TAVI/TAVR frame. The frame was delivered in the aortic valve position. Each of the pacemakers was activated one-by-one and the capture threshold values were collected.

Results, Conclusions, and Discussions: A total of 6 pacemakers implanted on the TAVI/TAVR frame were activated separately and the capture threshold values were obtained for 4 of those pacemakers. Two of those pacemakers were not able to capture the heart rhythm under various conditions (3.3 V LED, 60 bpm, 5 ms pulse width, 3.3 V LED, 75 bpm, 2 ms, 1.8 V LED, 75 bpm, 2ms) due to the location on the anterior portion of the left ventricle, where no conduction system is present.

Conclusion
The pacing from the aortic valve position was successfully performed, the Nitinol frame was used to mimic the TAVI/TAVR valve. Our array of NIR LED-activated pacemakers was able to successfully capture the heart rhythm of the heart and pacing in VVI mode was obtained. This is the foundation for the use of TAVI/TAVR valve with the pacemaker capabilities for pacing and resynchronization therapy of the heart arrhythmias, frequently observed during and after TAVI/TAVR valve implantation.

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