'Bionic' pacemaker reverses heart failure

Date:
February 7, 2022
Source:
University of Auckland
Summary:
A revolutionary pacemaker that re-establishes the heart's naturally
irregular beat is set to be trialled in New Zealand heart patients
this year.



FULL STORY ==========================================================================
A revolutionary pacemaker that re-establishes the heart's naturally
irregular beat is set to be trialled in New Zealand heart patients this
year, following successful animal trials. "Currently, all pacemakers pace
the heart metronomically, which means a very steady, even pace. But when
you record heart rate in a healthy individual, you see it is constantly on
the move," says Professor Julian Paton, a lead researcher and director
of Manaaki Manawa, the Centre for Heart Research at the University
of Auckland.


========================================================================== Manaaki Manawa has led the research and the results have just been
published in leading journal Basic Research in Cardiology.

"If you analyse the frequencies within your heart rate, you find the
heart rate is coupled to your breathing. It goes up on inspiration,
and it goes down on expiration, and that is a natural phenomenon in all
animals and humans. And we're talking about very ancient animals that
were on the planet 430 million years ago." Twelve years ago, Paton was a member of a group of scientists who decided to investigate the function
of this variability. They made a mathematical model that predicted it
saved energy. That made them question why a metronomic heartbeat was used
in heart-failure patients who lacked energy. They asked, "Why aren't we
pacing them with this variability?" All cardiovascular disease patients
lose the heart rate variability, which is an early sign that something
is going wrong. "People with high blood pressure, people with heart
failure, their heart rate is not being modulated by their breathing. It
may be a little bit, but it's very, very depressed, very suppressed,"
Paton says. "We decided that we would put the heart rate variability
back into animals with heart failure and see if it did anything good." Following positive signals in rats, the latest published research was
on a large animal model of heart failure, performed by Dr Julia Shanks
and Dr Rohit Ramchandra.



==========================================================================
"And the big news is that we believe we have now found a way to reverse
heart failure," Dr Ramchandra says.

Dr Julia Shanks, the research fellow who carried out the research,
explains, "There's nothing really on the market that will cure
heart failure. All the drugs will do is make you feel better. They
don't address the issue that you've got damaged tissue that's not
contracting as efficiently as it was. Our new pacemaker brings back
this variability, which of course is natural, in a way you could call
it 'nature's pacemaker'." Dr Ramchandra said, "Currently, pacemakers
trigger a metronomically steady beat, but this study shows introducing
a natural variation in the heartbeat improves the heart's ability
to pump blood through the body. The other big news is that we get a
20 percent improvement in cardiac output, which is effectively the
ability of the heart to pump blood through the body. And 20 percent is
a big number." "The pacemaker is almost like a bionic device," says
Paton. "It understands the signals from the body that tell the device
when we're breathing in and when we're breathing out. And then the
device has to communicate back to the body and pace the heart up during breathing in and down during breathing out." On seeing the results, interventional cardiologist Dr Wil Harrison from Middlemore Hospital in Auckland remarked: "Very interesting study. We do recognise clinically
that permanent pacing is 'non-physiological' to a certain degree, and pacing-induced cardiomyopathy is a well-recognised phenomenon. It will
be exciting to see if the findings translate over to humans." Dr Martin Stiles, a cardiologist from Waikato Hospital, in Hamilton, New Zealand,
who will lead the trial said: "We typically see improvements in heart
function with current pacemakers, but this bionic pacemaker has far
exceeded our expectations. This discovery may revolutionise how heart
failure patients are paced in the future." The next steps are well
under way, with plans to recruit patients into a trial planned for later
this year in New Zealand. The trial will be supported by Ceryx Medical,
a startup company that owns the IP on the unique electronics within the
bionic pacemaker. The study was funded by the Health Research Council
of New Zealand.

========================================================================== Story Source: Materials provided by University_of_Auckland. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. J. Shanks, Y. Abukar, N. A. Lever, M. Pachen, I. J. LeGrice, D. J.

Crossman, A. Nogaret, J. F. R. Paton, R. Ramchandra. Reverse
re-modelling chronic heart failure by reinstating heart rate
variability. Basic Research in Cardiology, 2022; 117 (1) DOI:
10.1007/s00395-022-00911-0 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220207172952.htm

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