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Electromechanical cardioplasty using a wrapped elasto-conductive epicardial mesh

 Jinkyung Park  ;  Suji Choi  ;  Ajit H. Janardhan  ;  Se-Yeon Lee  ;  Samarth Raut  ;  Joao Soares  ;  Kwangsoo Shin  ;  Shixuan Yang  ;  Chungkeun Lee  ;  Ki-Woon Kang  ;  Hye Rim Cho  ;  Seok Joo Kim  ;  Pilseon Seo  ;  Wonji Hyun  ;  Sungmook Jung  ;  Hye-Jeong Lee  ;  Nohyun Lee  ;  Seung Hong Choi  ;  Michael Sacks  ;  Nanshu Lu  ;  Mark E. Josephson  ;  Taeghwan Hyeon  ;  Dae-Hyeong Kim  ;  Hye Jin Hwang 
 Science Translational Medicine, Vol.8(344) : 344ra86, 2016 
Journal Title
 Science Translational Medicine 
Issue Date
Animals ; Cardiomyopathies/physiopathology ; Cardiomyopathies/surgery ; Electric Conductivity ; Heart Conduction System/surgery* ; Heart Failure/physiopathology ; Heart Failure/surgery ; Heart Rate/physiology ; Heart Ventricles/physiopathology ; Heart Ventricles/surgery ; Male ; Myocardial Contraction/physiology ; Myocardial Infarction/physiopathology ; Myocardial Infarction/surgery ; Rats, Sprague-Dawley ; Surgical Mesh*
Heart failure remains a major public health concern with a 5-year mortality rate higher than that of most cancers. Myocardial disease in heart failure is frequently accompanied by impairment of the specialized electrical conduction system and myocardium. We introduce an epicardial mesh made of electrically conductive and mechanically elastic material, to resemble the innate cardiac tissue and confer cardiac conduction system function, to enable electromechanical cardioplasty. Our epicardium-like substrate mechanically integrated with the heart and acted as a structural element of cardiac chambers. The epicardial device was designed with elastic properties nearly identical to the epicardial tissue itself and was able to detect electrical signals reliably on the moving rat heart without impeding diastolic function 8 weeks after induced myocardial infarction. Synchronized electrical stimulation over the ventricles by the epicardial mesh with the high conductivity of 11,210 S/cm shortened total ventricular activation time, reduced inherent wall stress, and improved several measures of systolic function including increases of 51% in fractional shortening, ~90% in radial strain, and 42% in contractility. The epicardial mesh was also capable of delivering an electrical shock to terminate a ventricular tachyarrhythmia in rodents. Electromechanical cardioplasty using an epicardial mesh is a new pathway toward reconstruction of the cardiac tissue and its specialized functions.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
이혜정(Lee, Hye Jeong) ORCID logo https://orcid.org/0000-0003-4349-9174
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