Overdrive pacing of spiral waves in a model of human ventricular tissue.

Abstract:

:High-voltage electrical defibrillation remains the only reliable method of quickly controlling life-threatening cardiac arrhythmias. This paper is devoted to studying an alternative approach, low-voltage cardioversion (LVC), which is based on ideas from non-linear dynamics and aims to remove sources of cardiac arrhythmias by applying high-frequency stimulation to cardiac tissue. We perform a detailed in-silico study of the elimination of arrhythmias caused by rotating spiral waves in a TP06 model of human cardiac tissue. We consider three parameter sets with slopes of the APD restitution curve of 0.7, 1.1 and 1.4, and we study LVC at the baseline and under the blocking of INa and ICaL and under the application of the drugs verapamil and amiodarone. We show that pacing can remove spiral waves; however, its efficiency can be substantially reduced by dynamic instabilities. We classify these instabilities and show that the blocking of INa and the application of amiodarone increase the efficiency of the method, while the blocking of ICaL and the application of verapamil decrease the efficiency. We discuss the mechanisms and the possible clinical applications resulting from our study.

journal_name

Sci Rep

journal_title

Scientific reports

authors

Pravdin SF,Epanchintsev TI,Panfilov AV

doi

10.1038/s41598-020-77314-5

subject

Has Abstract

pub_date

2020-11-26 00:00:00

pages

20632

issue

1

issn

2045-2322

pii

10.1038/s41598-020-77314-5

journal_volume

10

pub_type

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