An Investigation on Conductive Intracardiac Communication Dynamic Channel Gain During the Cardiac Cycle for Leadless Pacemakers

In galvanic coupling conductive intracardiac communication(GCCIC) of the leadless pacemakers, the electrical signal transmitted directly through the myocardium and blood is inevitably affected by the cardiac cycle. Established studies focused more on the effect of the myocardium. However, our preliminary in-vitro experiments suggested that blood volume variations also significantly impacted signal transmission. In this article, we analyzed the blood volume variations during the cardiac cycle and designed an in-vitro experimental platform containing a simulated heart beating system and an automatic channel characteristic acquisition system, which controlled two peristaltic pumps to realize the periodic blood volume variations and the continuous acquisition of channel gain. Through the in-vitro porcine heart experiment, the effect of frequency and blood volume variations during the cardiac cycle on two channel gains was analyzed. Considering the impact of high-frequency signal leakage, the channel gain variations of the low frequency are the main concern. The results showed that the channel gain was positively correlated with frequency; it changed periodically with blood volume variations in the cardiac cycle, and the trends were different due to the different signal paths of the two channels. For the Right Ventricle-Right Atrium channel, the gain varied from $-67$ dB to $-53$ dB and is inversely correlated with blood volume. The gain fluctuation range was smaller for the Right Ventricle-Left Ventricle channel, about 2 dB. This study shows that the gain of intracardiac communication channels, especially the RV-RA channel, is influenced by blood volume variations during the cardiac cycle.

Automated summary

This study analyzed the impact of blood volume variations during the cardiac cycle on the signal transmission of galvanic coupling conductive intracardiac communication (GCCIC) of leadless pacemakers. The in-vitro experiments showed that blood volume variations significantly affected channel gain, especially for the right ventricle-right atrium channel. The findings are important for understanding the working mechanism of leadless pacemakers.