Low energy defibrillation in human cardiac tissue: a simulation study.

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Low energy defibrillation in human cardiac tissue: a simulation study.

Please use this identifier to cite or link to this item: http://hdl.handle.net/10036/3779


Title: Low energy defibrillation in human cardiac tissue: a simulation study.
Author: Morgan, S. W.
Plank, G.
Biktasheva, I. V.
Biktashev, V. N.
Citation: Vol. 96 (4), pp. 1364 - 1373
Publisher: Biophysical Society
Journal: Biophysical Journal
Date Issued: 2009
URI: http://hdl.handle.net/10036/3779
DOI: 10.1016/j.bpj.2008.11.031
Links: http://dx.doi.org/10.1016/j.bpj.2008.11.031
Abstract: We aim to assess the effectiveness of feedback-controlled resonant drift pacing as a method for low energy defibrillation. Antitachycardia pacing is the only low energy defibrillation approach to have gained clinical significance, but it is still suboptimal. Low energy defibrillation would avoid adverse side effects associated with high voltage shocks and allow the application of implantable cardioverter defibrillator (ICD) therapy, in cases where such therapy is not tolerated today. We present results of computer simulations of a bidomain model of cardiac tissue with human atrial ionic kinetics. Reentry was initiated and low energy shocks were applied with the same period as the reentry, using feedback to maintain resonance. We demonstrate that such stimulation can move the core of reentrant patterns, in the direction that depends on the location of the electrodes and the time delay in the feedback. Termination of reentry is achieved with shock strength one-order-of-magnitude weaker than in conventional single-shock defibrillation. We conclude that resonant drift pacing can terminate reentry at a fraction of the shock strength currently used for defibrillation and can potentially work where antitachycardia pacing fails, due to the feedback mechanisms. Success depends on a number of details that these numerical simulations have uncovered.
Description: Copyright © 2009 Biophysical SocietyJournal Article
Keywords: AlgorithmsCardiac Pacing, ArtificialComputer SimulationElectric CountershockElectrodesFeedbackHeart Conduction SystemHumansMembrane PotentialsModels, CardiovascularSoftware

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