Turbulence control with local pacing and its implication in cardiac defibrillation

Area of Science:

• Nonlinear dynamics
• Complex systems
• Physiology

Background:

• Excitable systems exhibit complex spatio-temporal dynamics, including turbulence.
• Spiral wave breakup is a common source of turbulence in these systems.
• Controlling turbulence is crucial for understanding and treating phenomena like cardiac arrhythmias.

Purpose of the Study:

• To review and analyze turbulence control in excitable systems using local periodic pacing.
• To investigate the conditions and mechanisms for suppressing Winfree turbulence (WT) and defect turbulence (DT).
• To explore the applicability of local pacing to cardiac defibrillation.

Main Methods:

• Application of a local periodic pacing method to excitable systems.
• Analysis of turbulence suppression conditions and underlying mechanisms.
• Distinguishing between different types of defect turbulence (DT) and their response to pacing.

Main Results:

• Winfree turbulence (WT) can be consistently suppressed with optimized pacing parameters.
• Local pacing effectively controls DT arising from spiral tip motion instabilities.
• DT caused by wave propagation instabilities far from tips is not fully suppressed by pacing alone.
• An auxiliary gradient field method is proposed to enhance control for persistent DT.

Conclusions:

• Local periodic pacing is a viable strategy for controlling specific types of turbulence in excitable media.
• The effectiveness of pacing depends on the type and origin of the turbulence.
• Findings have implications for improving cardiac defibrillation strategies.