A quick primer on the electrical system of the heart followed by two major breakthroughs in pacemaker technology this year.
A leadless, subcutaneous defibrillator makes the list of 5 biggest medical breakthroughs of the year.
Boston Scientific has begun marketing a FIRST-OF-ITS-KIND DEFIBRILLATOR after receiving FDA approval in September. The implantable device, which protects against sudden cardiac arrest, was developed by a California firm purchased by Boston Scientific and is expected to be a financial win for the Natick-based company. Unlike others on the market, the S-ICD does not touch the heart, instead sending electrical pulses to correct abnormal rhythms through wires implanted just beneath the skin.
No More Batteries: Piezoelectric Pacemaker Powered By The Heart
An experimental device converts kinetic energy from beating hearts into electricitythan can power a pacemaker, meaning the chance for no more batteries in the future, according to a talk at the American Heart Association’s Scientific Sessions 2012.
The study is preliminary but a piezoelectric approach is promising for pacemakers because they require only small amounts of power to operate. Batteries must be replaced every five to seven years, which is costly and inconvenient. Piezoelectricity might also power other implantable cardiac devices like defibrillators, which also have minimal energy needs.
“Many of the patients are children who live with pacemakers for many years,” said M. Amin Karami, Ph.D., lead author of the study and research fellow in the Department of Aerospace Engineering at the University of Michigan in Ann Arbor. “You can imagine how many operations they are spared if this new technology is implemented.”
Researchers measured heartbeat-induced vibrations in the chest. Then, they used a “shaker” to reproduce the vibrations in the laboratory and connected it to a prototype cardiac energy harvester they developed. Measurements of the prototype’s performance, based on sets of 100 simulated heartbeats at various heart rates, showed the energy harvester performed as the scientists had predicted — generating more than 10 times the power than modern pacemakers require. The next step will be implanting the energy harvester, which is about half the size of batteries now used in pacemakers, Karami said. Researchers hope to integrate their technology into commercial pacemakers.
Two types of energy harvesters can power a typical pacemaker: linear and nonlinear. Linear harvesters work well only at a specific heart rate, so heart rate changes prevent them from harvesting enough power.
In contrast, a nonlinear harvester, the type used in the study, uses magnets to enhance power production and make the harvester less sensitive to heart rate changes. The nonlinear harvester generated enough power from heartbeats ranging from 20 to 600 beats per minute to continuously power a pacemaker. Devices such as cell phones or microwave ovens would not affect the nonlinear device, Karami said.
http://www.science20.com/news_articles/no_more_batteries_piezoelectric_pacemaker_powered_heart-96003
Rehabilitate Your Heart 
Interesting article here. I’d never heard of a development of a leadless ICD. I have an ICD and the lead on it has had to be replaced once due to an infection (Endocarditis). I was told I would need to have the batteries replaced every 5 – 7 years; so far it has been 4. This sounds like a wonderful development! Thanks for posting.
I read your post on your cardiac arrest how frightening. I am glad you came through the ordeal without serious consequences. I think it is a very interesting idea ICD without leads, as the leads can create problems. After having to get batteries replaced, one doesn’t want to go through more surgeries to have leads replaced. As my patients would say “might as well just put a zipper there”. don’t know how widely used this technology is though, it usually takes a few cowboy cardiologist to get things moving and work out the bugs, before becoming widely adopted across the country, but it is something to discuss with your cardiologist.