Research Updates: Novel Technologies Studies

Dr. Todor Mazgalev,
Director

Surgical treatment of AF has been the most effective form of treatment for those with reoccurring symptoms of the disease, but the search continues for effective treatments that do not require damage or destruction of cardiac tissue (e.g. ablations). AFIC's novel studies group, led by Dr. Todor Mazgalev, has focused on manipulating tissues surrounding the heart to affect atrial heart rhythm without the need for ablation. The principal targets have been (1) cardiac epicardial neural ganglia (fat pads adjacent to the heart), and (2) the vagus nerve near the heart. The principal partner for these efforts has been the Israeli company BioControl, Inc.

Biocontrol's implantable electrical stimulation
device

Modification of epicardial ganglia: One principal area of focus for Dr. Mazgalev's group has been electrical stimulation of the epicardial ganglia on the surface of the heart to control cardiac arrhythmias, particularly atrial fibrillation. AFIC's industry partner, BioControl, Inc., has developed an implantable device for electrical stimulation of the vagus nerve, and BioControl is working with Dr. Mazgalev to utilize this device for epicardial ganglia stimulation. AFIC is discussing partnerships to develop a custom set of leads for this device, and the surgical group's Dr. Gillinov will be developing minimally invasive robotic surgical techniques to access the ganglia for lead placement.Along the same lines, AFIC has partnered with Symphony Medical to investigate the effects of attenuating the activity of epicardial ganglia by applying bio-active materials such as alginate. Symphony continues to pursue this therapy.

Cervical vagal stimulation: AFIC has also partnered with BioControl to investigate electrical stimulation of the cervical vagus nerve for treatment of AF, and Biocontrol has developed and is testing a programmable implantable device for this purpose (see picture below). Experiments are underway to verify the therapeutic benefit of such stimulation – early animal experiments in the AFIC pre-clinical facilities have provided encouraging results. BioControl has devised several devices intended to be useful in this therapy, and with additional validation, will seek FDA approval for sales of such devices.