Optical mapping: pioneering the frontier of preclinical antiarrhythmic drug evaluation

Optical mapping has emerged as a unique technique in cardiac electrophysiology since its emergence in the 1970s. By acquiring high spatiotemporal resolution optical datasets using fluorescent dyes, this technique propels the progress of cardiac electrophysiology and the development of antiarrhythmic drug evaluation. This review outlines its application in drug evaluation, including the fundamental principles, major advantages, multiple electrophysiological parameters, and combination with other techniques for predicting proarrhythmic risk and identification of antiarrhythmic drugs. An overview of the drugs tested via the optical mapping method is presented, showcasing its extensive practical utility. This review provides a comprehensive framework for the analysis of arrhythmia mechanisms and drug development using optical mapping. Finally, its limitations and prospects of optical mapping in deciphering the arrhythmogenic mechanism and evaluating antiarrhythmic drugs are discussed, providing references for promoting its clinical translation.