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Tanabe Y, Ho JS, Liu J, Liao SY, Zhen Z, Hsu S, Shuto C, Zhu ZY, Ma A, Vassos C, Chen P, Tse HF, Poon ASY. High-performance wireless powering for peripheral nerve neuromodulation systems. PLoS One 2017; 12:e0186698. [PMID: 29065141 PMCID: PMC5655495 DOI: 10.1371/journal.pone.0186698] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 10/05/2017] [Indexed: 01/16/2023] Open
Abstract
Neuromodulation of peripheral nerves with bioelectronic devices is a promising approach for treating a wide range of disorders. Wireless powering could enable long-term operation of these devices, but achieving high performance for miniaturized and deeply placed devices remains a technological challenge. We report the miniaturized integration of a wireless powering system in soft neuromodulation device (15 mm length, 2.7 mm diameter) and demonstrate high performance (about 10%) during in vivo wireless stimulation of the vagus nerve in a porcine animal model. The increased performance is enabled by the generation of a focused and circularly polarized field that enhances efficiency and provides immunity to polarization misalignment. These performance characteristics establish the clinical potential of wireless powering for emerging therapies based on neuromodulation.
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Affiliation(s)
- Yuji Tanabe
- Department of Electrical Engineering, Stanford University, Stanford, California 94305, United States of America
| | - John S. Ho
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore 117583, Singapore
| | - Jiayin Liu
- Center for Innovation and Strategic Collaboration, St. Jude Medical, Inc., Orange County, California 92618, United States of America
| | - Song-Yan Liao
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Zhe Zhen
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Stephanie Hsu
- Department of Electrical Engineering, Stanford University, Stanford, California 94305, United States of America
| | - Chika Shuto
- Center for Innovation and Strategic Collaboration, St. Jude Medical, Inc., Orange County, California 92618, United States of America
| | - Zi-Yi Zhu
- Department of Medicine, University of Hong Kong, Hong Kong, China
| | - Andrew Ma
- Department of Electrical Engineering, Stanford University, Stanford, California 94305, United States of America
| | - Christopher Vassos
- Department of Electrical Engineering, Stanford University, Stanford, California 94305, United States of America
| | - Peter Chen
- Center for Innovation and Strategic Collaboration, St. Jude Medical, Inc., Orange County, California 92618, United States of America
| | - Hung Fat Tse
- Department of Medicine, University of Hong Kong, Hong Kong, China
- Hong Kong-Guangdong Joint Laboratory on Stem Cell and Regenerative Medicine, University of Hong Kong, Hong Kong, China
| | - Ada S. Y. Poon
- Department of Electrical Engineering, Stanford University, Stanford, California 94305, United States of America
- * E-mail:
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Liao SY, Liu Y, Zuo M, Zhang Y, Yue W, Au KW, Lai WH, Wu Y, Shuto C, Chen P, Siu CW, Schwartz PJ, Tse HF. Remodelling of cardiac sympathetic re-innervation with thoracic spinal cord stimulation improves left ventricular function in a porcine model of heart failure. Europace 2015; 17:1875-83. [PMID: 25767085 DOI: 10.1093/europace/euu409] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/30/2014] [Indexed: 12/15/2022] Open
Abstract
AIMS Thoracic spinal cord stimulation (SCS) has been shown to improve left ventricular ejection fraction (LVEF) in heart failure (HF). Nevertheless, the optimal duration (intermittent vs. continuous) of stimulation and the mechanisms of action remain unclear. METHODS AND RESULTS We performed chronic thoracic SCS at the level of T1-T3 (50 Hz, pulse width 0.2 ms) in 30 adult pigs with HF induced by myocardial infarction and rapid ventricular pacing for 4 weeks. All the animals were treated with daily oral metoprolol succinate (25 mg) plus ramipril (2.5 mg), and randomized to a control group (n = 10), intermittent SCS (4 h ×3, n = 10) or continuous SCS (24 h, n = 10) for 10 weeks. Serial measurements of LVEF and +dP/dt and serum levels of norepinephrine and B-type natriuretic peptide (BNP) were measured. After sacrifice, immunohistological studies of myocardial sympathetic and parasympathetic nerve sprouting and innervation were performed. Echocardiogram revealed a significant increase in LVEF and +dP/dt at 10 weeks in both the intermittent and continuous SCS group compared with controls (P < 0.05). In both SCS groups, there was diffuse sympathetic nerve sprouting over the infarct, peri-infarct, and normal regions compared with only the peri-infarct and infarct regions in the control group. In addition, sympathetic innervation at the peri-infarct and infarct regions was increased following SCS, but decreased in the control group. Myocardium norepinephrine spillover and serum BNP at 10 weeks was significantly decreased only in the continuous SCS group (P < 0.05). CONCLUSIONS In a porcine model of HF, SCS induces significant remodelling of cardiac sympathetic innervation over the peri-infarct and infarct regions and is associated with improved LV function and reduced myocardial norepinephrine spillover.
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Affiliation(s)
- Song-Yan Liao
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Yuan Liu
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Mingliang Zuo
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Yuelin Zhang
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Wensheng Yue
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Ka-Wing Au
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Wing-Hon Lai
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Yangsong Wu
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Chika Shuto
- Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, St Paul, MN, USA
| | - Peter Chen
- Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, St Paul, MN, USA
| | - Chung-Wah Siu
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China Research Center of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Peter J Schwartz
- IRCCS Istituto Auxologico Italiano, Center for Cardiac Arrhythmias of Genetic Origin, Milan, Italy
| | - Hung-Fat Tse
- Cardiology Division, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China Research Center of Heart, Brain, Hormone and Healthy Aging, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China Shenzhen Institutes of Research and Innovation, University of Hong Kong, Hong Kong, China
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Tse HF, Turner S, Sanders P, Okuyama Y, Fujiu K, Cheung CW, Russo M, Green MD, Yiu KH, Chen P, Shuto C, Lau EO, Siu CW. Thoracic Spinal Cord Stimulation for Heart Failure as a Restorative Treatment (SCS HEART study): First-in-man experience. Heart Rhythm 2015; 12:588-595. [DOI: 10.1016/j.hrthm.2014.12.014] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Indexed: 12/28/2022]
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Liu Y, Zuo M, Liao S, Zhang Y, Au K, De Rama R, Shuto C, Chen P, Siu C, Tse H. Catheter-based renal denervation improves cardiac function in a porcine model of ischemic heart failure. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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