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Nonlinear-dynamical arrhythmia control in humans.

D J Christini1, K M Stein, S M Markowitz

  • 1Department of Medicine, Division of Cardiology, Cornell University Medical College, New York, NY 10021, USA. dchristi@med.cornell.edu

Proceedings of the National Academy of Sciences of the United States of America
|April 26, 2001
PubMed
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Nonlinear-dynamical control, or chaos control, successfully stabilized human cardiac rhythms in patients. This demonstrates the clinical feasibility of using chaos control for treating arrhythmias.

Area of Science:

  • Cardiovascular physiology
  • Nonlinear dynamics
  • Clinical electrophysiology

Background:

  • Nonlinear-dynamical control (chaos control) effectively manages physical systems.
  • In vitro studies show potential for controlling excitable biological tissues.
  • Clinical application in human physiological processes remained unproven.

Purpose of the Study:

  • To demonstrate the clinical feasibility of nonlinear-dynamical control in humans.
  • To modulate human cardiac electrophysiological dynamics.
  • To stabilize unstable cardiac rhythms.

Main Methods:

  • Applied nonlinear-dynamical control techniques to human subjects.
  • Targeted pacing-induced period-2 atrioventricular-nodal conduction alternans.

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  • Stabilized the underlying unstable steady-state conduction.

    • Main Results:

    • Successfully terminated pacing-induced atrioventricular-nodal conduction alternans in 52/54 attempts.
    • Demonstrated rapid stabilization of an unstable target rhythm.
    • Confirmed clinical feasibility in five human patients.

    Conclusions:

    • Nonlinear-dynamical control is clinically feasible for human cardiac electrophysiology.
    • This technique can stabilize unstable rhythms, offering a basis for arrhythmia treatment.
    • Paves the way for advanced control strategies for complex clinical arrhythmias.