Abstract
Abstract Introduction: Therapies for substrate-related arrhythmias
include ablation or drugs targeted at altering conductive properties or
disruption of slow zones in heterogeneous myocardium. Conductive
compounds such as carbon nanotubes may provide a novel personalizable
therapy for arrhythmia treatment by allowing tissue homogenization.
Methods: A nanocellulose-carbon nanotube conductive hydrogel was
developed to have conduction properties similar to normal myocardium. Ex
vivo perfused canine hearts were studied. Electroanatomic activation
mapping of the epicardial surface was performed at baseline, after
radiofrequency ablation, and after uniform needle injections of the
conductive hydrogel through the injured tissue. Gross histology was used
to assess distribution of conductive hydrogel in the tissue. Results:
The conductive hydrogel viscosity was optimized to decrease with
increasing shear rate to allow expression through a syringe. The DC
conductivity under aqueous conduction was 4.3·10-1 S/cm. In 4 canine
hearts, when compared to the homogeneous baseline conduction, isochronal
maps demonstrated sequential myocardial activation with a shift in
direction of activation to surround the edges of the ablated region.
After injection of conductive hydrogel, isochrones demonstrated
conduction through the ablated tissue with activation similar to
baseline in all 4 hearts. Gross specimen examination demonstrated
retention of the hydrogel within the tissue. Conclusions: This
proof-of-concept study demonstrates that conductive hydrogel can be
injected into acutely disrupted myocardium to restore conduction. Future
experiments should focus on evaluating long-term retention and
biocompatibility of the hydrogel through in vivo experimentation.