The role of pulse timing in cardiac defibrillation

Frontiers in Network Physiology

Network Physiology

Thomas Lilienkamp¹  Ulrich Parlitz²  Stefan Luther³  Joshua Steyer⁴ 

[1] Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany;Faculty for Applied Mathematics, Physics, and General Science, Computational Physics for Life Science, Nuremberg Institute of Technology Georg Simon Ohm, Nürnberg, Germany;Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany;nstitute for the Dynamics of Complex Systems, Georg-August-Universität Göttingen, Göttingen, Germany;German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany;Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany;nstitute for the Dynamics of Complex Systems, Georg-August-Universität Göttingen, Göttingen, Germany;German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany;Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen, Germany;Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany;nstitute for the Dynamics of Complex Systems, Georg-August-Universität Göttingen, Göttingen, Germany;Institute of Biomedical Engineering, Karlsruhe Institute of Technology, Karlsruhe, Germany;

关键词: cardiac arrhythmias;    defibrillation;    electrophysiology;    biophysical methods;    dose-response curve;    spiral waves;    spatiotemporal chaos;    nonlinear dynamics;   

DOI  :  10.3389/fnetp.2022.1007585

 received in 2022-07-30, accepted in 2022-10-28,  发布年份 2023

来源: Frontiers

【 摘 要 】

Life-threatening cardiac arrhythmias require immediate defibrillation. For state-of-the-art shock treatments, a high field strength is required to achieve a sufficient success rate for terminating the complex spiral wave (rotor) dynamics underlying cardiac fibrillation. However, such high energy shocks have many adverse side effects due to the large electric currents applied. In this study, we show, using 2D simulations based on the Fenton-Karma model, that also pulses of relatively low energy may terminate the chaotic activity if applied at the right moment in time. In our simplified model for defibrillation, complex spiral waves are terminated by local perturbations corresponding to conductance heterogeneities acting as virtual electrodes in the presence of an external electric field. We demonstrate that time series of the success rate for low energy shocks exhibit pronounced peaks which correspond to short intervals in time during which perturbations aiming at terminating the chaotic fibrillation state are (much) more successful. Thus, the low energy shock regime, although yielding very low temporal average success rates, exhibits moments in time for which success rates are significantly higher than the average value shown in dose-response curves. This feature might be exploited in future defibrillation protocols for achieving high termination success rates with low or medium pulse energies.

【 授权许可】

Unknown   
Copyright © 2023 Steyer, Lilienkamp, Luther and Parlitz.