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

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

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dc.contributor.author Morgan, S. W. en_US
dc.contributor.author Plank, G. en_US
dc.contributor.author Biktasheva, I. V. en_US
dc.contributor.author Biktashev, V. N. en_US
dc.date.accessioned 2012-09-28T17:59:19Z en_US
dc.date.accessioned 2013-03-20T12:27:17Z
dc.date.issued 2009 en_US
dc.description.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. en_US
dc.identifier.citation Vol. 96 (4), pp. 1364 - 1373 en_US
dc.identifier.doi 10.1016/j.bpj.2008.11.031 en_US
dc.identifier.uri http://hdl.handle.net/10036/3779 en_US
dc.language.iso eng en_US
dc.publisher Biophysical Society en_US
dc.relation.url http://dx.doi.org/10.1016/j.bpj.2008.11.031 en_US
dc.subject Algorithms en_US
dc.subject Cardiac Pacing, Artificial en_US
dc.subject Computer Simulation en_US
dc.subject Electric Countershock en_US
dc.subject Electrodes en_US
dc.subject Feedback en_US
dc.subject Heart Conduction System en_US
dc.subject Humans en_US
dc.subject Membrane Potentials en_US
dc.subject Models, Cardiovascular en_US
dc.subject Software en_US
dc.title Low energy defibrillation in human cardiac tissue: a simulation study. en_US
dc.date.available 2012-09-28T17:59:19Z en_US
dc.date.available 2013-03-20T12:27:17Z
exeter.contacts.depositing-owner-email Biktashev, Vadim <V.N.Biktashev@exeter.ac.uk> en_US
exeter.contacts.depositing-owner-email Biktashev, Vadim <V.N.Biktashev@exeter.ac.uk> en_US
exeter.contacts.owner-email Biktashev, Vadim <V.N.Biktashev@exeter.ac.uk> en_US
exeter.contacts.owner-email Biktashev, Vadim <V.N.Biktashev@exeter.ac.uk> en_US
exeter.place-of-publication United States en_US
dc.description Copyright © 2009 Biophysical Society en_US
dc.description Journal Article en_US
dc.identifier.journal Biophysical Journal en_US


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