Chance To Build Inspires Kityee Au-Yeung

By Claire Cusick, August 2004

Kityee Au-YeungThe best part about graduate school for Kityee Au-Yeung? Building things from scratch."I like the part where you get to make a lot of your own decisions about what to try," she said.

Au-Yeung is getting to do just that in her research. She is building a pacemaker-like implant that will help monitor and study atrial fibrillation, a common cardiac disorder. To build it, she has had to study existing literature on similar research, determine her device’s major functions, design and build a prototype, and test it.

"I have to pretty much do everything from start to finish," she said.

Au-Yeung is used to doing things on her own. She came to Maui, Hawaii, from her home in Hong Kong to attend Seabury Hall, a boarding school, when she was 16.

"That was a big change," she said. She was away from her family during the week, and only saw an aunt and uncle on weekends. Plus, in Hong Kong, she had been a city dweller. Maui was a beach town. It was like living in a vacation spot.

"I was bored. I was a teenager," she said with a laugh, thinking about life in Maui. "These are things that you appreciate later on!"

She spoke some English as a result of having taken required English classes, but now was forced to speak it every day. There were few other Chinese-speaking students at her school. So she didn’t enjoy her American Literature classes very much.

"I hated Huck Finn," she said.

But they say math is the universal language, and she excelled in math and science. She also learned independence, and didn’t find the transition to college to be difficult.

When it came time to choose her major at Duke, she was attracted to the health-improving aspect of biomedical engineering. She earned her undergraduate degree in 1999, and decided to pursue her Ph.D. One day, hopefully, her work will help people.

"Working toward that goal is more interesting to me than building a better TV," she said.

Kityee works in the Experimental Electrophysiology Lab, under the supervision of Professor Patrick Wolf. On his web site, Prof. Wolf describes the goal of their research:

"One thrust of the cardiac-based work is centered on atrial fibrillation and in particular on very low energy atrial defibrillation strategies. The goal is to produce a device that can defibrillate the atria with a painless series of electrical impulses."

Atrial fibrillation, according to, is "the most common form of irregular heartbeat (arrhythmia)." A normal heart’s electrical system controls the rhythm of a heartbeat.

"But in atrial fibrillation, abnormal electrical impulses cause the upper chambers of the heart (atria) to fibrillate, or quiver, resulting in irregular and rapid beating of the ventricles, the heart’s main pump.

"As a result, the heart pumps less efficiently, reducing blood flow to the body and to the heart muscle itself."

Although it’s not a life-threatening condition for most people, atrial fibrillation leaves people vulnerable to strokes, and, according to, "if the heart rate is fast and uncontrolled over a long period, atrial fibrillation can damage the heart and lead to heart attack and heart failure."

A common method to prevent atrial fibrillation, according to, is to have a person take antiarrhythmic medications. "These drugs work mostly by stabilizing the heart muscle tissue or slowing the heart rate."

If prevention doesn’t work, the current procedure to interrupt an episode of atrial fibrillation, Au-Yeung said, is called electrical cardioversion, during which an electric shock is administered to a person’s heart, attempting to resynchronize it and restore its natural rhythm.

"Instead of using a single high-energy shock to defibrillate, maybe we can treat it with a series of lower-energy ones," she said.

Her device – currently about the size of a deck of cards -- will hopefully treat the condition differently. It will act like a two-part pacemaker: first, it can transmit electrocardiograms (ECGs) to a computer outside the patient’s body, so information could be relayed to a remote computer in a doctor’s office. After reviewing the patient’s ECG, the doctor can decide an appropriate pacing therapy. Pacing instructions can be sent back to the device to deliver pacing pulses to the heart, literally remotely.

"That would be the ideal future application of this system," Au-Yeung said.

After she’s earned her degree, she’d like to take a vacation. After that, she’s thinking of heading west. One summer, she did an internship with a startup company – NeuroPace, which was developing an implantable device for the treatment of epilepsy through brain stimulation -- in California. She liked California, and the liked working on a team in the hardware division. Everyone there was young and focused.

"That’s the environment that I would look for again," she said.

Regardless of where she ends up, she’d like to work in design. "More of the hands-on design part is what interests me," she said.