Method to prevent propagation of irregular electromechanical waves in the myocardium by creating lines of increased tissue conductivity
The present invention relates to compositions, methods, and devices for preventing irregular electromechanical waves in the myocardium that lead to pathological conditions as arrhythmia. In particular, the invention relates to compositions and methods to increase the conductivity of the myocardium to restore an impairment of the electrical conduction system of the heart. To that end substances with high conductivity, as carbon nanotube suspensions or metal nanowire suspensions, are injected in the myocardium at closely adjacent locations on circular or open lines or are introduced in patches of cardiomyocytes that are subsequently placed on the myocardium.
1 . A method of treating irregular electromechanical waves in the myocardium of a subject with a cardiovascular disease, the method comprising injection of a conductive suspension into the myocardium on one or more lines, wherein the one or more lines are circular lines perpendicular to the electrical axis of the heart or open lines; wherein the open lines are selected from a group consisting of lines along the left bundle of His, lines along the atrioventricular node, and lines located along affected parts of the electrical conduction system,
wherein the conductive suspension comprises carbon micro particles or noble metal micro particles, and
wherein the injection along circular or open lines supports synchronized depolarizations of cardiomyocytes.
2 . The method of claim 1 , wherein the conductive suspension has a conductivity of at least 1×10 3 S/m at 298 K.
3 . The method of claim 1 , wherein the cardiovascular disease is selected from the group consisting of arrhythmia, atrial fibrillation, first, second or third-degree atrioventricular node block, left, right or trifascicular bundle branch block, sinus node dysfunction, Bachmann bundle dysfunction, atrial conducting disorder, His bundle dysfunction, pathological alterations of the electrical conduction system of the heart, dysfunction of the electro-mechanical coupling, mitochondrial or sarcomere disorders, metabolic diseases as M. Wilson, channelopathies, ischemia, fibrosis or inflammation of the myocardium, and iatrogenic defects of the myocardium as consequence of ablation therapy.
4 . The method of claim 1 , wherein the circular lines serve as equipotential lines and inhibit rotating electromechanical waves.
5 . The method of claim 1 , wherein the open lines are in the right atrium (RA) at locations along lines following the location of the left bundle of His, or at locations on a line along the atrioventricular node.
6 . The method of claim 1 , wherein the conductive suspension is injected into the myocardium through an injection catheter.
7 . The method of claim 6 , wherein the injection catheter comprises a catheter tube, and an injection device configured to be moved in and out of the catheter.
8 . The method of claim 6 , wherein the injection catheter comprises an inflatable balloon configured to unfold a cage in the RA and a cage comprising injection ducts and injection needles for injecting said conductive suspension at locations on one or several circular lines.
9 . A method of treating or preventing irregular electromechanical waves in the myocardium of a subject with a cardiovascular disease, comprising:
introducing in patches of cardiomyocytes the conductive suspension of claim 1 ; and
placing the patches of cardiomyocytes on the myocardium in a defined orientation, thereby effecting placement of the conductive suspension on the myocardium in one or more lines,
wherein the one or more lines are circular lines perpendicular to the electrical axis of the heart or open lines; wherein the open lines are selected from a group consisting of lines along the left bundle of His, lines along the atrioventricular node, and lines located along affected parts of the electrical conduction system, and
wherein the placement along circular or open lines supports synchronized depolarizations of cardiomyocytes.
10 . The method of claim 1 , wherein the one or more lines are circular lines perpendicular to the electrical axis of the heart and the cardiovascular disease is arrhythmia or left atrial tachycardia.
11 . The method of claim 10 , wherein the arrhythmia is selected from atrial arrhythmia, atrial fibrillation, atrial flutter, ventricular arrhythmia, and focal arrhythmia in patients with ischemic scars.
12 . The method of claim 1 , wherein the one or more lines are open lines located along affected parts of the electrical conduction system, and the cardiovascular disease is a disorder of the electrical conduction system.
13 . The method of claim 12 , wherein the disorder of the electrical conduction system is selected from the group consisting of first, second or third-degree atrioventricular node block, left, right or trifascicular bundle branch block, sinus node dysfunction, Bachmann bundle dysfunction, His bundle dysfunction, dysfunction of the electro-mechanical coupling, and iatrogenic defects of the myocardium as consequence of ablation therapy.