There are over 26 million people suffering with heart failure in the world. Caring for these individuals consumes about two percent of all national healthcare budgets. Even worse, the 50-percent mortality rate for these patients is roughly five years. This highlights the need for better preventative and care strategies. Available medications certainly help improve symptoms, but they do little if anything for reversing underlying problems. And many of these individuals have associated heart rhythm disturbances that can be life-threatening. These are often managed with a pacemaker of the heart. But traditional pacemakers fail to improve heart function otherwise. This is an area that scientists and clinicians would like to better address.
Recent studies out of New Zealand now suggest, however, that new approaches to heart failure may be around the corner. Researchers have been investigating a bionic that not only corrects irregular heart rhythms but actually improves heart failure. While these studies have only been performed in animals thus far, human trials will begin soon. If the results are the same, then this innovative pacemaker of the heart could be a game-changer. It has the potential to save billions of dollars globally in heart failure management. And it could significantly improve quality of life and longevity for patients with heart conditions. Plus, researchers even envision their device being utilized for non-cardiac illnesses in the future.
“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.” – Professor Julian Paton, Director, Manaaki Manawa, the Centre for Heart Research at the University of Auckland, New Zealand
Heart Failure and Traditional Pacemakers
In terms of heart failure, there can be different causes. Some who suffer heart attacks will have residual heart muscle damage that can lead to heart failure. This is why innovative heart disease prevention techniques are being pursued. (Read more about nanoparticles as a biomedical therapy in this Bold story.) Others may have leaky heart valves that may cause this as well. In both cases, changes in the muscle can lead to cardiac arrythmias. Because the electrical rhythm generators exist partially within the heart muscle, this is not an uncommon occurrence. And the standard of care is to manage these patients with medications and/or a pacemaker of the heart. But a traditional pacemaker of the heart operates like a metronome…a steady, rhythmic beat. But scientists have long known this is not how the heart’s rhythm typically behaves.
With normal heart function, the heart’s rhythm varies with each breath we take. When we inhale, our heart rate increases slightly. When we exhale, the opposite occurs. However, patients with heart failure lose this natural variability in their heart rhythm. As a result of heart muscle injury, the normal association of the heart’s rhythm with breathing is significantly diminished. Researchers are now learning how important these rhythmic variations are based on recent studies. And while a traditional pacemaker of the heart does little to change this, a bionic pacemaker can.
“…[T]his 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.” – Dr. Rohit Ramchandra, Researcher, Department of Cardio-physiology, University of Auckland, New Zealand
The Promise of a Bionic Pacemaker
For the last five years, researchers in New Zealand have been working on a bionic pacemaker. The University of Auckland has been working with Ceryx Medical, a startup biotechnology company based on Wales. The bionic pacemaker device they have developed goes by the name of Cysoni, and several animal trials have now been conducted. In these trials, heart failure animals wearing the bionic pacemaker demonstrated significant improvements in overall heart function. Once the heart rhythm was better coupled with breathing patterns, the heart began to pump much more efficiently. In fact, some of the animals showed a 20 percent improvement in pumping abilities. Considering a traditional pacemaker of the heart shows only minor benefits in pumping function, these findings are substantial.
At a more cellular level, researchers found more profound evidence that their bionic pacemaker induces heart failure improvement. Heart muscle cells require T-tubules in the muscle to allow for a strong muscular contraction. This leads to better pumping abilities of the heart. Unlike a regular pacemaker of the heart, the bionic pacemaker improved T-tubule function. Plus, other pathologic changes of heart muscle cells, like unhealthy enlargement, was reversed. As a result, the animals with these devices showed significant improvements in exercise performance. This combination of cellular repair and improved function are reasons why scientists are so enthusiastic about the Cysoni device.
“We typically see improvements in heart function with current pacemakers, but this bionic pacemaker has far exceeded our expectations. This discovery may revolutionize how heart failure patients are paced in the future.” – Dr. Martin Stiles, Cardiologist, Waikato Hospital, New Zealand
Human Trials to Follow
Ceryx Medical and University of Auckland researchers are planning to move forward with human trials in the near future. After performing rigorous testing on their bionic pacemaker for the last half-decade, they believe they’re ready for this next step. If successful, Ceryx Medical stands to reap their benefits of their efforts. Owning the patent for their unique biotechnology, they would be the first-to-market with this new approach. Likewise, researchers involved in the latest studies also see this as being revolutionary in terms of heart failure patient care. They foresee this as a disruptive technology that could make the typical pacemaker of the heart obsolete.
While human research and subsequent approval for a bionic pacemaker is likely a few years away, its potential is significant. This primarily applies to heart failure management, but researchers suggest these variability pacemakers could improve other health conditions. For instance, some with cognitive impairment might see improved memory and concentration using such devices. Other types of organ failure patients may also benefit from enhanced cardiac pumping efficiency. These are areas that will require further investigation. But for now, many see the bionic pacemaker as the future of heart failure management.
