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Synchronization as a mechanism for low-energy anti-fibrillation pacing
Yanyan Claire Ji1, Ilija Uzelac1, Niels Otani2
1School of Physics, Georgia Institute of Technology, Atlanta, Georgia.
Heart Rhythm
|May 16, 2017
Summary
Low-energy anti-fibrillation pacing (LEAP) effectively terminates atrial and ventricular fibrillation with significant energy reduction. Synchronization is the key mechanism, and pacing effectiveness improves with optimized shock timing and period.
Area of Science:
- Cardiovascular Electrophysiology
- Medical Device Technology
Background:
- Low-energy anti-fibrillation pacing (LEAP) offers a lower-energy alternative to standard defibrillation for symptomatic fibrillation.
- LEAP has the potential to reduce energy requirements in treating cardiac arrhythmias.
Purpose of the Study:
- To elucidate the mechanism of arrhythmia termination by LEAP.
- To analyze how shock period and timing influence LEAP's success rate.
Main Methods:
- Induced atrial and ventricular fibrillation in isolated canine hearts.
- Applied LEAP and standard defibrillation for termination.
- Utilized a 2D bidomain human atrial model for simulations.
Main Results:
- LEAP successfully terminated both atrial and ventricular fibrillation with 88% and 81% energy reduction, respectively.
- Synchronization via virtual electrodes was identified as the primary termination mechanism.
- Simulations indicated optimal LEAP efficacy when shock period aligns with the dominant period and shocks are timed with decreasing Fraction of Tissue Excited (FTE).
Conclusions:
- Synchronization is confirmed as the mechanism for LEAP-mediated arrhythmia termination.
- Adjusting shock period and timing can enhance the effectiveness of LEAP.
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