A revolutionary pacemaker that re-establishes the heart’s naturally irregular beat is set to be trialed in heart patients this year, following successful animal trials.

The pacemaker was developed by a group of scientists at the Centre for Heart Research at the University of Auckland (Auckland, New Zealand).

“Currently, all pacemakers pace the heart metronomically, which means a very steady, even pace. But when you record heart rate in a healthy individual, you see it is constantly on the move,” said Professor Julian Paton, a lead researcher and director of Manaaki Manawa, the Centre for Heart Research at the University of Auckland. “If you analyze the frequencies within your heart rate, you find the heart rate is coupled to your breathing. It goes up on inspiration, and it goes down on expiration, and that is a natural phenomenon in all animals and humans. And we’re talking about very ancient animals that were on the planet 430 million years ago.”

The group of scientists decided to investigate the function of this variability. They made a mathematical model that predicted it saved energy. That made them question why a metronomic heartbeat was used in heart-failure patients who lacked energy. They asked, “Why aren’t we pacing them with this variability?” All cardiovascular disease patients lose the heart rate variability, which is an early sign that something is going wrong.

“People with high blood pressure, people with heart failure, their heart rate is not being modulated by their breathing. It may be a little bit, but it’s very, very depressed, very suppressed,” explained Paton. “We decided that we would put the heart rate variability back into animals with heart failure and see if it did anything good.”

Following positive signals in rats, the latest published research was on a large animal model of heart failure. The next steps are well under way, with plans to recruit patients into a trial planned for later this year in New Zealand. 

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