An international research team has shown for the first time that cardiac stimulation with transcutaneous ultrasound energy delivery is feasible and can be done safely in patients. An international research team has shown for the first time that cardiac stimulation with transcutaneous ultrasound energy delivery is feasible and can be done safely in patients.

The pacing leads that are used with cardiac stimulation devices are associated with a number of complications including dislodgement, infection, and fracture. The present technology avoids these problems by eliminating a pacing lead altogether, according to the report in the Journal of the American College of Cardiology for August 28.

"There is no similar technology demonstrated on human so far. Our group had performed a similar study using ultrasound energy on pigs," lead author Dr. Kathy L. Lee told Reuters Health.

The novel technology, evaluated in 24 patients by Dr. Lee, from the University of Hong Kong, and colleagues, uses an external ultrasound transmitter placed on the chest wall to send energy to a receiver electrode placed in the heart. The receiver converts the ultrasound energy to an electrical square wave output, to pace the heart.

Eighty pacing sites were evaluated in the study: 35 right ventricular, 33 left ventricular, and 12 right atrial. The average transmit-to-receive distance was 11.3 cm.

Pacing was achieved at all sites with consistent capture at all but three. The average mechanical index while pacing was 0.5 and the mean capture threshold was 1.01 V.

Ultrasound-mediated pacing was well tolerated and no adverse effects were seen, the authors report.

This technology "has the advantages of avoiding the complications inherent to pacing leads and accessibility to different locations within various cardiac chambers enabling selective-site and multisite pacing. The development of implantable receiver electrodes holds hope for a new paradigm in pacemaker therapy," the researchers conclude.

Still, "it may be a long way to make this technology applicable to clinical use," Dr. Lee noted. Meanwhile, "We have performed a study on heart failure patients as cardiac resynchronization therapy is one potential application of this technology," she added.

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