Synchronization as a mechanism for low-energy anti-fibrillation pacing

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Yanyan Claire JiFlavio H Fenton

Abstract

Low-energy anti-fibrillation pacing (LEAP) has been suggested as an alternative treatment in symptomatic fibrillation patients. It significantly lowers the energy required compared with standard 1-shock defibrillation. In this study, we investigated the mechanism of arrhythmia termination by LEAP and systematically analyzed the influence of shock period and timing on the success rate of LEAP. We induced atrial and ventricular fibrillation in isolated canine hearts and applied LEAP and standard 1-shock defibrillation to terminate the arrhythmia. We simulated the arrhythmia and LEAP using a 2-dimensional bidomain human atrial model. The ex vivo experiments showed successful termination of atrial fibrillation and ventricular fibrillation using LEAP, with an average 88% and 81% energy reduction, respectively, and both experiments and simulations verified that synchronization from virtual electrodes is the key mechanism for termination of arrhythmia by LEAP using modified Kuramoto phase plots and fraction of tissue excited (FTE) plots. We also observed in simulations that LEAP is more effective when the shock period is close to the dominant period and the first shock is delivered when FTE is decreasing. Our results support synchroni...Continue Reading

Citations

May 26, 2020·Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences·Matthew J Hoffman, Elizabeth M Cherry
Jan 3, 2020·Chaos·Andrea J WelshFlavio H Fenton
Nov 5, 2019·Scientific Reports·Angel MorenoJason D Bayer
Oct 10, 2020·Computers in Biology and Medicine·Anthony GuzmanLaura Muñoz

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