From engineering to the cardiovascular field: Figuring out the possibilities and challenges of the Intracardiac leadless pacemakers (ICLPs)

Since the beginning, Majid Khazaee's interest in engineering came from the strong possibility of solving society’s problems. For over 8 years now, Majid has focused on creating precise mechanical systems and he has worked with piezoelectric materials for a long time. Thus, the major challenge of battery life in ICLPs sparked Majid’s interest and became the beginning of a journey into the cardiovascular field. 

Intracardiac leadless pacemakers (ICLPs) tackle many issues in the traditional pacemaker and have demonstrated to have fewer infections. However, the battery life of ICLPs is around 10 years which is often seen in devices such as Micra. Another important limitation is that ICLPs cannot be retrieved again after long-term use. These challenges related to the technology’s battery remain unclear due to its novelty. Consequently, the psychological fear of the low battery levels and the non-removable nature of ICLPs restrict their use among young patients. 

Initially, when Majid delved into the cardiovascular field, he saw the possibility to help society by solving tough problems using his skills from engineering. He reflects upon hearing about the challenge in ICLPs for the first time: “I immediately felt, “This is challenging enough for me and it can also help society.” So, I entered the field without hesitation”.

During Majid’s time in the cardiovascular field, he had conversations with doctors at Aalborg University about the psychological consequences of the battery life in leadless pacemakers for patients. These conversations became a key source of inspiration as Majid recollects: “I felt deeply moved because I could imagine the fear of knowing your heart’s battery might stop at any moment. The decision was clear — I wanted to help in every way I could”.

A new innovation for better patient treatment

Working with piezoelectric materials for years provided Majid the background for his new research project combining his experiences and skills in mechanical engineering with his interest in the cardiovascular field. Thus, the project of the self-powering leadless pacemaker using piezoelectric energy harvesting began as a solution to the challenge of battery life.

The human heart constantly produces enormous kinetic energy and harvesting this energy with high-performance piezoelectric materials could be the start of a fundamental medical change according to Majid. The project is promising and Majid is hopeful of a future with better patient treatment as he reflects on the progress of his research: “We’ve shown that enough energy for heart pacing can be generated from the heart’s own movement. Our system worked for 60 weeks under accelerated lab conditions, with only minor changes”, Majid states. 

Connecting two distinctive fields: engineering and medicine

Interdisciplinary work combining the two fields of engineering and medicine has many benefits such as enabling new innovations that provide better and faster treatments for patients. This allows for researchers with diverse perspectives to collaborate and work towards new solutions. However, the field of engineering and the field of medicine also have many differences. 

According to Majid, the focus in engineering is “accuracy and understanding exactly what happens in a physical process. This is because there aren’t many unknowns”. This differs greatly from medicine where Majid emphasises the complexity of physiological processes and randomness which creates many unknowns. He also adds: “Each animal or human is unique. I believe this makes medicine more complex and less predictable”.

Addressing interdisciplinary challenges and funding within the field

For Majid, combining two fields is not an easy task and proposes numerous challenges. These challenges might be intimidating to address for some but not for Majid.

When interviewing Majid about this project, Majid addresses his concerns with interdisciplinarity: the lack of understanding each other’s strength in the field of engineering and medicine. He emphasises: “The biggest challenge is that engineering and medicine don’t fully understand each other’s strengths. As a result, cross-field research is not well integrated. Each field has limited knowledge of the other, which makes interdisciplinary work time-consuming”. 

Another issue Majid highlights is funding. According to Majid he experiences that medical funding agencies are often sceptical towards engineering while engineering funding sources often view the field of medicine as “too complex, highly regulated, and risky, so they doubt the ideas will be practical. These mindsets make it hard to build strong connections between the two fields”, Majid explains. However, this has not held him back from attempting to connect the two distinctive fields.

The five year goal

Looking into the future, the next step for Majid’s research project is: “To integrate this system with commercial pacemaker electronics and solve the challenge of making materials that can last over 50 years”. 

Due to the complexity and high reliability needed, it is hard to say when this new technology will be completely ready however Majid believes his team’s estimate of five years is a reasonable goal. 

Majid’s greatest hope for the future

In the future, connecting engineering and medicine has a vast potential which can lead to new innovations and opportunities providing better treatment for patients. In the words of Majid: “I see great potential in using smart materials like piezoelectric to solve medical problems. In the long term, I hope to build strong synergy between smart materials and medical applications”.

While overcoming medical challenges is not easy, Majid is driven by the hope of one day being able to provide patients with a self-charging leadless pacemaker as he concludes: “In the mid term, the day a patient receives a self-charging leadless pacemaker will be the happiest day of my life”.