The power of optogenetics : Potential in cardiac experimental and clinical electrophysiology

Optogenetics is an emerging, interdisciplinary research area which combines genetic and optical technologies to steer and monitor specific biological processes. To this end, light-activated proteins, so-called optogenetic actuators, or fluorescent sensor proteins are genetically targeted to the cells of interest. Light activation can then be used to modulate or record cellular behaviour with high spatiotemporal precision. In cardiac research, optogenetic approaches have been used to unravel heterocellular electrotonic interactions, both in vitro and in situ. Pioneering optogenetic studies with potential relevance for clinical electrophysiology include light-controlled pacing experiments and optical defibrillation studies. However, despite successful implementation in mouse models, clinical applications are not feasible to date; these will require major advances in gene therapy and in optical techniques.