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Catheter-integrated soft multilayer electronic arrays for multiplexed sensing and actuation during cardiac surgery

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Abstract

The rigidity and relatively primitive modes of operation of catheters equipped with sensing or actuation elements impede their conformal contact with soft-tissue surfaces, limit the scope of their uses, lengthen surgical times and increase the need for advanced surgical skills. Here, we report materials, device designs and fabrication approaches for integrating advanced electronic functionality with catheters for minimally invasive forms of cardiac surgery. By using multiphysics modelling, plastic heart models and Langendorff animal and human hearts, we show that soft electronic arrays in multilayer configurations on endocardial balloon catheters can establish conformal contact with curved tissue surfaces, support high-density spatiotemporal mapping of temperature, pressure and electrophysiological parameters and allow for programmable electrical stimulation, radiofrequency ablation and irreversible electroporation. Integrating multimodal and multiplexing capabilities into minimally invasive surgical instruments may improve surgical performance and patient outcomes.

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Fig. 1: Multimodal, multiplexed soft sensors and actuators for minimally invasive surgery.
Fig. 2: Design, assembly and characterization of the array of 3D pressure sensors.
Fig. 3: Therapeutic functions.
Fig. 4: Simultaneous, multimodal operation.
Fig. 5: Multifunctionality of instrumented balloon catheters demonstrated with Langendorff rabbit heart models.
Fig. 6: Endocardial electrophysiological studies on Langendorff human heart models.

Data availability

The main data supporting the results in this study are available within the paper and its Supplementary Information. Source data for the figures are available from figshare with the identifier https://doi.org/10.6084/m9.figshare.12631835.

Code availability

The custom MATLAB software for data analysis can be downloaded from https://github.com/optocardiography.

Change history

  • 10 September 2020

    The Peer Review file originally published with this Article was an old version; the updated file is now available.

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Acknowledgements

I.R.E. and J.A.R. acknowledge support from the Leducq Foundation project RHYTHM and R01-HL141470. This project was supported by the National Institute of General Medical Sciences of the National Institutes of Health under grant nos. P41 GM103545 and R24 GM136986, and the Nora Eccles Harrison Cardiovascular Research and Training Institute (CVRTI). K.A. acknowledges support from the National Institutes of Health K99-HL148523-01A1. X.C. acknowledges support from National Key R&D Program of China (grant 2018YFA0108100) and China Scholarship Council. This work made use of the NUFAB facility of Northwestern University’s NUANCE Center, which has received support from the Soft and Hybrid Nanotechnology Experimental (SHyNE) Resource (NSF ECCS-1542205); the MRSEC program (NSF DMR-1720139) at the Materials Research Center; the International Institute for Nanotechnology (IIN); the Keck Foundation; and the State of Illinois, through the IIN.

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M.H., L.C., K.A., R.G., Y.H., I.R.E. and J.A.R. conceived the ideas, designed the experiments and wrote the manuscript; L.C., K.L. and G.Y. performed mechanical, electrical and thermal modelling. M.H., C. Liang, B.S., J.-H.K., Q.Y., Y.M., E.S., J.M.B., Y.L., C. Liu and J.B.M. fabricated the devices; M.H., X.C., H.Z., B.S., W.B., Y.M. and W.L. performed in vitro data collection and analysis; M.H., K.A., H.Z. and N.R.F. performed ex vivo data collection and analysis.

Corresponding authors

Correspondence to Yonggang Huang or Igor R. Efimov or John A. Rogers.

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Supplementary information

Supplementary Information

Supplementary notes, figures, tables and video captions.

Reporting Summary

Supplementary Video 1

Temperature mapping using the multiplexing circuit with proper grounding.

Supplementary Video 2

Pressure mapping on a porcine heart.

Supplementary Video 3

Electrogram mapping on a rabbit heart.

Supplementary Video 4

Temperature mapping during radiofrequency ablation.

Supplementary Video 5

Electrogram mapping on a human heart.

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Han, M., Chen, L., Aras, K. et al. Catheter-integrated soft multilayer electronic arrays for multiplexed sensing and actuation during cardiac surgery. Nat Biomed Eng 4, 997–1009 (2020). https://doi.org/10.1038/s41551-020-00604-w

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