Julian Paton, currently Professor of Translational Physiology at ABI, began studying the relationship between the heartbeat and respiration more than a decade ago while at Bristol's School of Physiology, Pharmacology & Neuroscience. He has since worked with his team at UK-based Ceryx Medical, the company he founded while at Bristol, to develop ‘Cysoni’, a unique cardiac rhythm management device.
The bionic device paces the heart with real-time respiratory modulation. The innovation stems from the idea that heart rate increases and decreases with each breath in normal physiology, termed ‘respiratory sinus arrhythmia’ (RSA). Cysoni replicates this natural interaction, triggering heartbeats based on respiratory function, as opposed to the usual ‘metronomic’ generation by traditional pacemakers. This sets Cysoni apart from existing devices, which generate an output with no breath-by-breath induced variation in the inter-beat interval. In essence, Cysoni listens and responds to the cardiorespiratory system and optimises its performance.
The team’s studies found that RSA pacing increased cardiac output by 20 per cent, compared to monotonic pacing. This increase in output led to a significant decrease in heart failure-associated symptoms such as apnoeas and significant improvements in performance during exercise. It also reversed cardiomyocyte hypertrophy and restored the T-tubule structure that is essential for force generation. This repair of the cardiac damage indicative of heart failure is particularly exciting.
Pre-clinical data showing a dramatic improvement in directly recorded cardiac output in heart failure has now been published in the international journal, Basic Research in Cardiology.
Professor Paton, said: “We are delighted to have our data published, and hope that the advancements we are making in cardiovascular treatment will excite the global healthcare community, as well as giving hope to patients themselves. Five years of rigorous testing have led us to the stage of being ready to begin clinical trials later this year.”
Of the 26-million heart failure patients worldwide, around 50 per cent die within five years of diagnosis.
Dr Stuart Plant, CEO of Ceryx Medical, believes that Cysoni stands to dramatically improve not just the existing health and wellbeing of cardiology patients, but also their prognoses.
Dr Plant explained: “We are seeing, at single heart cell level, repair to the structure of that cell because of the reinstatement of RSA via Cysoni. It’s a huge scientific breakthrough. The improvement in the function of the heart combined with the repair of the heart muscle stands to dramatically improve therapy for patients with cardiac diseases such as heart failure. And while cardiology remains our firm focus for the time being, we anticipate our technology being used to treat conditions including hypertension and spinal cord injuries, and even dementia.”
Professor Gianni Angelini, British Heart Foundation Professor of Cardiac Surgery at the University of Bristol’s Bristol Heart Institute and the National Heart and Lung Institute, Imperial College London, added: “This is a very important result because current pacemakers never give us such a large improvement in cardiac pumping. If this translates across to humans it may define the way we pace hearts in the future.”
The first clinical study involving the Cysoni technology will begin later this year involving patients from hospitals in the UK, Australia, and New Zealand.
Update 11 May 2022: The University of Bristol and University of Bath spin out CeryxM has secured nearly £4 million in seed funding to develop to commercialise its cardiology technology and commence the first-in-human clinical study of Ceryx's cardiac rhythm management device, Cysoni, later this year.