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Soft Robot. 2017 Sep;4(3):241-250. doi: 10.1089/soro.2016.0076. Epub 2017 May 30.

An Implantable Extracardiac Soft Robotic Device for the Failing Heart: Mechanical Coupling and Synchronization.

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1 John A. Paulson Harvard School of Engineering and Applied Science, Harvard University , Cambridge, Massachusetts.
2 Wyss Institute for Biologically Inspired Engineering, Harvard University , Cambridge, Massachusetts.
3 Boston Children's Hospital , Harvard Medical School, Boston, Massachusetts.
4 Department of Mechanical Engineering, Technical University of Munich , Munich, Germany .
5 Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology , Cambridge, Massachusetts.
6 Discipline of Biomedical Engineering, College of Engineering and Informatics, National University of Ireland , Galway, Ireland .
7 Department of Cardiovascular and Thoracic Surgery, University of Louisville School of Medicine , Louisville, Kentucky.


Soft robotic devices have significant potential for medical device applications that warrant safe synergistic interaction with humans. This article describes the optimization of an implantable soft robotic system for heart failure whereby soft actuators wrapped around the ventricles are programmed to contract and relax in synchrony with the beating heart. Elastic elements integrated into the soft actuators provide recoiling function so as to aid refilling during the diastolic phase of the cardiac cycle. Improved synchronization with the biological system is achieved by incorporating the native ventricular pressure into the control system to trigger assistance and synchronize the device with the heart. A three-state electro-pneumatic valve configuration allows the actuators to contract at different rates to vary contraction patterns. An in vivo study was performed to test three hypotheses relating to mechanical coupling and temporal synchronization of the actuators and heart. First, that adhesion of the actuators to the ventricles improves cardiac output. Second, that there is a contraction-relaxation ratio of the actuators which generates optimal cardiac output. Third, that the rate of actuator contraction is a factor in cardiac output.


artificial muscle; direct cardiac compression; heart failure; robotic implant; soft actuation; ventricular assist device


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