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In Vivo Restoration of Myocardial Conduction With Carbon Nanotube Fibres

Title	In Vivo Restoration of Myocardial Conduction With Carbon Nanotube Fibres
Authors	Mark D. McCauley, Flavia Vitale, J. Stephen Yan, Colin C. Young, Brian Greet, Marco Orecchioni, Srikanth Perike, Abdelmotagaly Elgalad, Julia A. Coco, Mathews John, Doris A. Taylor, Luiz C. Sampaio, Lucia G. Delogu, Mehdi Razavi, Matteo Pasquali
Magazine	Circulation: Arrhythmia and Electrophysiology
Date	08/01/2019
DOI	10.1161/CIRCEP.119.007256
Introduction	Re-entrant arrhythmias are primarily caused by compromised myocardial conduction. Carbon nanotube fibres (CNTf), which combine the mechanical attributes of suture materials with the conductive properties of metals, present a promising restorative approach for impaired myocardial conduction. Acute open-chest electrophysiology studies were conducted in sheep (n=3). Epicardial conduction delay was induced via radiofrequency ablation, followed by the application of CNTf and then silk suture controls. In rodents, CNTf were surgically implanted across the right atrioventricular junction, with subsequent acute (n=3) and chronic (4-week, n=6) electrophysiology studies. Rodent toxicity assessments (n=10) were also performed, alongside electrical analysis of the CNTf-myocardial interface. Across all large animal studies, CNTf consistently enhanced conduction velocity. The acute rodent model demonstrated ventricular pre-excitation during sinus rhythm. All chronic cases showed a return of AV conduction, though atrial pacing was necessary. No gross or histopathological signs of toxicity were observed. Ex vivo studies indicated that the contact impedance of CNTf was significantly lower than that of platinum-iridium. This research demonstrates that carbon nanotube fibres, when sewn across epicardial scar in sheep, acutely improve conduction. Furthermore, CNTf maintain conduction for one month after atrioventricular nodal (AVN) ablation in rats, without inflammatory or toxic responses, but only under paced conditions. The minimal impedance at the CNTf/myocardial interface allows CNTf to facilitate localized, downstream myocardial activation. As conductive, biocompatible materials, CNTf restore electrical conduction in diseased myocardium, offering potential long-term restorative solutions for pathologies that disrupt efficient electrical signal transduction in electrically excitable tissues.
Quote	Mark D. McCauley, Flavia Vitale and J. Stephen Yan et al. In Vivo Restoration of Myocardial Conduction With Carbon Nanotube Fibres. Circulation: Arrhythmia and Electrophysiology. 2019. Vol. 12(8). DOI: 10.1161/CIRCEP.119.007256
Element	Carbon (C) , Platinum (Pt) , Iridium (Ir)
Industry	Medical Devices , Research & Laboratory

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