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In Vivo Mechanical Loading Conditions of Pectorally Implanted Cardiac Pacemakers

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Cardiovascular and Cardiac Therapeutic Devices

Part of the book series: Studies in Mechanobiology, Tissue Engineering and Biomaterials ((SMTEB,volume 15))

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Abstract

With technological progress enabling new patient populations and smaller devices, detailed data on mechanical in vivo loads become increasingly important to ensure reliability of implantable medical devices. Employing a system for remote measurement of in vivo mechanical loadings on fully implantable pacemaker, pre-clinical investigations on in-line force and transverse reaction force of the Pectoralis major were conducted in the Chacma baboon. Based on an intra-species correlation derived from these investigations, a simplified physiological model and a mechanical equivalent model were developed for a sub-muscular pectoral device implant considering the Pectoralis major, Pectoralis minor and rib cage. By assessing the morphometric and mechanical parameters of these musculoskeletal structures and associated model parameters, the intra-species correlation was shown to exhibit robustness for a larger intra-species subject population and a linear scale variance allowing the application to humans under consideration of the inter-species difference of the attachment angles of the Pectoralis major. The transfer function provides a basis for the prediction of patient-specific maximum mechanical loadings on a sub-muscular pectoral cardiac pacemaker implant through non- or minimal invasive measurements on the patient. This study demonstrated the feasibility of the approach for assessment of in vivo mechanical loading conditions of implantable pacemakers.

An erratum to this chapter is available at 10.1007/8415_2013_167.

An erratum to this chapter can be found at http://dx.doi.org/10.1007/8415_2013_167

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Abbreviations

ai :

Coefficients of inter-species transfer function for i = 1 to 5

FIL :

In-line force generated in the sternal Pectoralis major

FT :

Transverse force acting on the IPM/pectoral implant

kr :

Transverse stiffness coefficient of the rib cage

kt1 :

Transverse stiffness coefficient of the Pectoralis major

kt2 :

Transverse stiffness coefficient of the Pectoralis minor

Lf :

Muscle fibre length

Lf,opt :

Optimal muscle fibre length

Lm :

Length of the sternal Pectoralis major along the estimated line of action

Lr :

Characteristic length of the rib cage determined by the rib geometry and curvature

Mb :

Body mass of subject

Mm :

Mass of the entire Pectoralis major

N:

Number of subjects

QIL :

Uniformly distributed in-line force along the width of the Pectoralis major over the pectoral implant

tm :

Thickness of the sternal Pectoralis major at the location of the IPM/pectoral implant

tm,cb :

Thickness of the sternal Pectoralis major at crossbar of the buckle force transducer

tmu :

Thickness of the Pectoralis minor at the location of the IPM implant

Vm :

Volume of the entire Pectoralis major

wm :

Width of the Pectoralis major over the IPM/pectoral implant

wm,cb :

Width of the Pectoralis major at the cross bar of the buckle transducer

ψ1 :

Angle of attachment of the Pectoralis major at its origin

\( \bar{\psi }_{ 1} \) :

Mean angle of attachment of the Pectoralis major at its origin for n subjects

ψ2 :

Angle of attachment of the Pectoralis major at its insertion

\( \bar{\psi }_{ 2} \) :

Mean angle of attachment of the Pectoralis major at its insertion for n subjects

θ:

Pennation angle of the skeletal muscle fibres

ρm :

Material density of Pectoralis major

σm :

Axial stress in the Pectoralis major during contraction

σmu :

Axial stress in the Pectoralis minor during contraction

B:

Baboon

H:

Human

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Acknowledgments

The authors thank Professor Stephen Beningfield, Petronella Samuels, Sharon Heyne and Nazlea Behardien-Peters of the Department of Radiology, University of Cape Town, for MRI and CT imaging.

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Authors and Affiliations

  1. Cardiovascular Research Unit, Chris Barnard Department of Cardiothoracic Surgery, University of Cape Town, Observatory, South Africa

    Thomas Franz, Michael Hamman de Vaal, Jacques Scherman & Peter Zilla

  2. Programme for the Enhancement of Research Capacity, Research Office, University of Cape Town, Mowbray, South Africa

    Thomas Franz

  3. Centre for Research in Computational and Applied Mechanics, University of Cape Town, Rondebosch, South Africa

    Thomas Franz

  4. Cardiac Rhythm Disease Management, Medtronic Inc, Minneapolis, MN, USA

    James Neville

  5. Neuromodulation Division, Medtronic Inc, Minneapolis, MN, USA

    Micah Litow

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    Thomas Franz

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Franz, T., de Vaal, M.H., Neville, J., Scherman, J., Litow, M., Zilla, P. (2013). In Vivo Mechanical Loading Conditions of Pectorally Implanted Cardiac Pacemakers. In: Franz, T. (eds) Cardiovascular and Cardiac Therapeutic Devices. Studies in Mechanobiology, Tissue Engineering and Biomaterials, vol 15. Springer, Berlin, Heidelberg. https://doi.org/10.1007/8415_2013_160

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  • DOI: https://doi.org/10.1007/8415_2013_160

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