There is an urgent clinical need for a treatment regimen that addresses the underlying pathophysiology of ventricular arrhythmias, the leading cause of sudden cardiac death. The current report describes the design of an injectable hydrogel electrode and successful deployment in a pig model with access far more refined than any current pacing modalities allow. In addition to successful cardiac capture and pacing, analysis of surface ECG tracings and three-dimensional electroanatomic mapping revealed a QRS morphology comparable to native sinus rhythm, strongly suggesting the hydrogel electrode captures the deep septal bundle branches and Purkinje fibers. In an ablation model, electroanatomic mapping data demonstrated that the activation wavefront from the hydrogel reaches the mid-myocardium and endocardium much earlier than current single-point pacing modalities. Such uniform activation of broad swaths of tissue enables an opportunity to minimize the delayed myocardial conduction of heterogeneous tissue that underpins re-entry. Collectively, these studies demonstrate the feasibility of a new pacing modality that most closely resembles native conduction with the potential to eliminate lethal re-entrant arrhythmias and provide painless defibrillation.

临床迫切需要一种治疗方案来解决室性心律失常的潜在病理生理学，室性心律失常是心源性猝死的主要原因。目前的报告描述了可注射水凝胶电极的设计，并在养猪模型中成功部署，其访问性比当前任何起搏模式所允许的都要精细得多。除了成功的心脏捕获和起搏外，表面心电图描记和三维电解剖标测分析显示 QRS 形态与天然窦性心律相当，强烈表明水凝胶电极捕获深间隔束支和浦肯野纤维。在消融模型中，电解剖标测数据表明，来自水凝胶的激活波前比目前的单点起搏方式更早到达心肌中段和心内膜。这种大片组织的均匀激活使有机会最大限度地减少支撑折返折返的异质组织的延迟心肌传导。总的来说，这些研究证明了一种与自然传导最相似的新起搏方式的可行性，有可能消除致命的折返性心律失常并提供无痛除颤。