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Mechanisms of vortices termination in the cardiac muscle

D Hornung1, V N Biktashev2, N F Otani3

  • 1Max Planck Institute DS , BMPG, Gottingen, Germany.

Royal Society Open Science
|April 14, 2017
PubMed

Insights

We developed a method using electric field pulses to terminate cardiac vortices, which are key to fibrillation. This approach offers a new basis for developing effective, low-energy defibrillation techniques.

Area of Science:

  • Cardiovascular Physiology
  • Nonlinear Dynamics
  • Medical Engineering

Background:

  • Cardiac fibrillation is often sustained by multiple vortices.
  • Existing defibrillation methods lack precision in targeting these vortices.
  • The precise mechanisms and locations of cardiac vortices remain challenging to identify.

Purpose of the Study:

  • To propose and validate a method for terminating multiple cardiac vortices.
  • To establish a physical basis for novel low-energy defibrillation strategies.

Main Methods:

  • Scanning pinned vortex phases in parallel using electric field pulses (E-pulses).
  • Defining pacing parameter conditions for guaranteed single vortex termination.
  • Conducting approximately 500 experiments on isolated pig hearts to terminate ventricular fibrillation.

Main Results:

  • A condition for guaranteed termination of a single vortex was specified.
  • Termination of multiple vortices with differing frequencies showed success rates below one, dependent on chance.
  • Evidence suggests hidden pinned vortices play a significant role in fibrillation.
  • A similar termination mechanism was observed for free vortices.

Conclusions:

  • The proposed E-pulse scanning method provides a potential solution for terminating multiple cardiac vortices.
  • The findings support the hypothesis that vortices are significant drivers of fibrillation.
  • This research lays the groundwork for developing new, low-energy defibrillation methods targeting cardiac vortices.

Keywords:
cardiac fibrillationimplantable defibrillatornonlinear wavesweakly pinned vortices

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