Low energy stimuli for spiral wave dynamics control

JORGE CASTRO, MATÍAS RAFTI, ALBERTO ALBESA, JORGE CARBALLIDO-LANDEIRA, FLAVIO H. FENTON AND ALBERTO P. MUÑUZURIA

Leon

Congreso; 5th International Scientific Conference on Physics and Control; 2011

5th International Scientific Conference on Physics and Control

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide affecting 2.2 million people in the United States alone. Complications associated with chronic AF include increased risk for both thromboembolism and stroke. Left untreated, paroxysmal AF often progresses to permanent AF, which is resistant to therapy. Although underlying anatomic or pathophysiological factors may fuel this progression, AF itself may lead to its own perpetuation through electric, structural, and metabolic remodeling of atrial tissue. The realization that AF begets AF has led to management strategies that are designed to avoid the progression of AF by reducing the frequency and duration of AF episodes [1].Among these strategies, a new method to terminate fast atrial tachycardias and AF has been recently developed within the context of animal experimentation [2]. In this method, electrodes located at a small distance from the heart deliver a train of low-voltage shocks at a rapid rate. The idea underlying is that during the low-energy shocks, small intrinsic conductivity discontinuities behave as internal “virtual” electrodes that actually serve as activation sites (or secondary sources) if the field strength depolarizes the tissue beyond the excitation threshold. This method presents many advantages comparing with previous methods.