Non-invasive Electro Stimulation Technologies for the Diagnosis and Therapy of Coronary Artery Disease and Heart Arrhythmias

The Centre of Excellence STIMCARD operating within the Institute of Medical Equipment and Technology ITAM develops Polish technologies of transesophageal, transcutaneous and transvenous cardiac stimulation as well as technologies supporting the supervision of patients undergoing electrocardiotherapy, such as in the case of an implanted pacemaker or cardioverter defibrillator. The paper reviews non-invasive electro stimulation techniques, as well as the diagnosis and therapy of the coronary artery disease (CAD) and arrhythmias. As far as CAD is concerned, the paper presents solutions applied in the construction of electrodes and pacemakers intended for both transesophageal and transcutaneous cardiac stimulation tests. The clinical value of the developed cardiac stimulation test has been assessed for the diagnosis of stable cardiac symptoms and management of patients with unstable cardiac disease, as well as for the identification of subjects in danger of sudden cardiac death. The system of stimulated ischemic preconditioning has also been discussed. Also, the paper demonstrates dedicated solutions used in ECG recording channels in the area of diagnosis and treatment of arrhythmias. The solutions make it possible to obtain stable and interpretable recordings during stimulation, both on the surface of the body and in the esophagus. Finally, the paper analyses solutions introduced in pacemakers which make it possible to induce (for diagnostic purposes) and stabilize quick paroxysmal heart arrhythmias, as well as the idea of supported hemodynamics, particularly useful during surgery.