A physical approach to remove anatomical reentries: a bidomain study

Controlling cardiac chaos is often achieved by applying a large damaging electric shock-defibrillation. It removes all waves, without differentiating reentries and normal waves, anatomical and functional reentries. Anatomical reentries can be removed by anti-tachycardia pacing (ATP) as well. But ATP requires the knowledge of the position of the reentry, and an access to it with an invasive stimulating electrode. We show that the physics of electric field distribution between cardiac cells permits one to deliver an electric pulse exactly to the core of an anatomical reentry, without knowing its position and even to locations where access with a stimulating electrode is not possible. The energy needed is two orders of magnitude less than defibrillation energy. The results are insensitive to both a detailed ionic model and to the geometry of the fibers.