The Heart of the Matter

bme2016
July 03, 2017

Since 1958, average life expectancy in the US has increased by 10 years. According to Igor Efimov, the inaugural chair of GW’s Department of Biomedical Engineering and the Alisann and Terry Collins Professor of Biomedical Engineering, the 68 percent reduction in the mortality rate from heart disease during the same period is a huge contributor to this remarkable gain in life expectancy.

That said, heart disease still remains the country’s number one killer, and Dr. Efimov has dedicated his life’s work to better understanding and developing devices to treat it.

Historically, much of the fundamental cardiovascular research has been conducted through experiments on animals, with scientists and engineers hoping to translate what they learn about the physiology and functioning of the various animals’ hearts to the human heart. But there are inherent limits in studying animal hearts. Frustrated by these limits, Dr. Efimov developed a program at his previous university (Washington University in St. Louis) to procure human hearts during transplantation to study them in the lab.

“This was exciting, because for the first time we were able to test many physiological mechanisms of disease in humans,” Dr. Efimov recalls. “Essentially we found that many ideas that worked in animals also work in humans, but many do not. Unfortunately, the translational value from many of these [animal] studies is rather limited and has had a relatively small impact on human health.”

Medical devices, on the other hand, have had a large and extremely beneficial impact on treatment of heart disease, with pacemakers and defibrillators helping millions of patients. But no medical devices exist yet to treat atrial fibrillation, a form of arrhythmia (or irregular heartbeat) that can cause dangerously rapid heart rates and stroke. The only current treatment is ablation, which burns and kills the tissue in the heart that is causing the arrhythmia.

Dr. Efimov, however, sees a potential treatment in a particularly novel technology developed by Dr. John Rogers of University of Illinois at Urbana-Champaign, and the two are working together to develop new devices based on this technology. Dr. Rogers and other materials scientists have developed flexible, membrane-like electronics devices that will wrap around an organ and monitor its functions. Seeing applications of this for treatment of heart disease, Dr. Efimov began collaborating with Dr. Rogers to develop an implantable, custom-fit device that wraps around a patient’s heart.

“It conducts 24/7 monitoring of the function of the organ and, if needed, you can terminate dangerous states such as atrial or ventricular fibrillation,” says Dr. Efimov. “This is what I want to continue doing at GW.”