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Efficient termination of cardiac arrhythmias using optogenetic resonant feedback pacing

MPS-Authors
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Hussaini,  Sayedeh
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Mamyraiym Kyzy,  Aidai       
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Schröder-Schetelig,  Johannes
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Lädke,  Sarah Louisa
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Venkatesan,  Vishalini
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Diaz-Maue,  Laura
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Quiñonez Uribe,  Raul Alejandro
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Richter,  Claudia
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Majumder,  Rupamanjari
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Krinski,  Valentin
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Luther,  Stefan
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Citation

Hussaini, S., Mamyraiym Kyzy, A., Schröder-Schetelig, J., Lädke, S. L., Venkatesan, V., Diaz-Maue, L., et al. (2024). Efficient termination of cardiac arrhythmias using optogenetic resonant feedback pacing. Chaos: an interdisciplinary journal of nonlinear science, 34: 031103. doi:10.1063/5.0191519.


Cite as: https://hdl.handle.net/21.11116/0000-000F-9D06-A
Abstract
Malignant cardiac tachyarrhythmias are associated with complex spatiotemporal excitation of the heart. The termination of these lifethreatening arrhythmias requires high-energy electrical shocks that have significant side effects, including tissue damage, excruciating pain, and worsening prognosis. This significant medical need has motivated the search for alternative approaches that mitigate the side effects, based on a comprehensive understanding of the nonlinear dynamics of the heart. Cardiac optogenetics enables the manipulation of cellular function using light, enhancing our understanding of nonlinear cardiac function and control. Here, we investigate the efficacy of optically resonant feedback pacing (ORFP) to terminate ventricular tachyarrhythmias using numerical simulations and experiments in transgenic Langendorff perfused mouse hearts. We show that ORFP outperforms the termination efficacy of the optical single-pulse (OSP) approach. When using ORFP, the total energy required for arrhythmia termination, i.e., the energy summed over all pulses in the sequence, is 1 mJ. With a success rate of 50%, the energy per pulse is 40 times lower than with OSP with a pulse duration of 10 ms. We demonstrate that even at light intensities below the excitation threshold, ORFP enables the termination of arrhythmias by spatiotemporal modulation of excitability inducing spiral wave drift.