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Hussaini S, Mamyraiym Kyzy A, Schröder-Schetelig J, Lädke SL, Venkatesan V, Diaz-Maue L, Quiñonez Uribe RA, Richter C, Biktashev VN, Majumder R, Krinski V, Luther S. Efficient termination of cardiac arrhythmias using optogenetic resonant feedback pacing. CHAOS (WOODBURY, N.Y.) 2024; 34:031103. [PMID: 38526981 DOI: 10.1063/5.0191519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 01/03/2024] [Indexed: 03/27/2024]
Abstract
Malignant cardiac tachyarrhythmias are associated with complex spatiotemporal excitation of the heart. The termination of these life-threatening arrhythmias requires high-energy electrical shocks that have significant side effects, including tissue damage, excruciating pain, and worsening prognosis. This significant medical need has motivated the search for alternative approaches that mitigate the side effects, based on a comprehensive understanding of the nonlinear dynamics of the heart. Cardiac optogenetics enables the manipulation of cellular function using light, enhancing our understanding of nonlinear cardiac function and control. Here, we investigate the efficacy of optically resonant feedback pacing (ORFP) to terminate ventricular tachyarrhythmias using numerical simulations and experiments in transgenic Langendorff-perfused mouse hearts. We show that ORFP outperforms the termination efficacy of the optical single-pulse (OSP) approach. When using ORFP, the total energy required for arrhythmia termination, i.e., the energy summed over all pulses in the sequence, is 1 mJ. With a success rate of 50%, the energy per pulse is 40 times lower than with OSP with a pulse duration of 10 ms. We demonstrate that even at light intensities below the excitation threshold, ORFP enables the termination of arrhythmias by spatiotemporal modulation of excitability inducing spiral wave drift.
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Affiliation(s)
- S Hussaini
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen 37075, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Göttingen 37075, Germany
| | - A Mamyraiym Kyzy
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
| | - J Schröder-Schetelig
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen 37075, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Göttingen 37075, Germany
| | - S L Lädke
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
| | - V Venkatesan
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
| | - L Diaz-Maue
- DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Göttingen 37075, Germany
- Research Electronics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
| | - R A Quiñonez Uribe
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Göttingen 37075, Germany
| | - C Richter
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Göttingen 37075, Germany
- WG Cardiovascular Optogenetics, Lab Animal Science Unit, Leibniz Institute for Primate Research, Göttingen 37077, Germany
| | - V N Biktashev
- Department of Mathematics and Statistics, University of Exeter, Exeter EX4 4QF, United Kingdom
| | - R Majumder
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen 37075, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Göttingen 37075, Germany
| | - V Krinski
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
| | - S Luther
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organisation, Göttingen 37077, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen 37075, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Göttingen 37075, Germany
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Hussaini S, Lädke SL, Schröder-Schetelig J, Venkatesan V, Quiñonez Uribe RA, Richter C, Majumder R, Luther S. Dissolution of spiral wave's core using cardiac optogenetics. PLoS Comput Biol 2023; 19:e1011660. [PMID: 38060618 PMCID: PMC10729946 DOI: 10.1371/journal.pcbi.1011660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/19/2023] [Accepted: 11/04/2023] [Indexed: 12/20/2023] Open
Abstract
Rotating spiral waves in the heart are associated with life-threatening cardiac arrhythmias such as ventricular tachycardia and fibrillation. These arrhythmias are treated by a process called defibrillation, which forces electrical resynchronization of the heart tissue by delivering a single global high-voltage shock directly to the heart. This method leads to immediate termination of spiral waves. However, this may not be the only mechanism underlying successful defibrillation, as certain scenarios have also been reported, where the arrhythmia terminated slowly, over a finite period of time. Here, we investigate the slow termination dynamics of an arrhythmia in optogenetically modified murine cardiac tissue both in silico and ex vivo during global illumination at low light intensities. Optical imaging of an intact mouse heart during a ventricular arrhythmia shows slow termination of the arrhythmia, which is due to action potential prolongation observed during the last rotation of the wave. Our numerical studies show that when the core of a spiral is illuminated, it begins to expand, pushing the spiral arm towards the inexcitable boundary of the domain, leading to termination of the spiral wave. We believe that these fundamental findings lead to a better understanding of arrhythmia dynamics during slow termination, which in turn has implications for the improvement and development of new cardiac defibrillation techniques.
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Affiliation(s)
- Sayedeh Hussaini
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Germany
| | - Sarah L. Lädke
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
| | - Johannes Schröder-Schetelig
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Germany
| | - Vishalini Venkatesan
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
| | - Raúl A. Quiñonez Uribe
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Germany
| | - Claudia Richter
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Germany
- WG Cardiovascular Optogenetics, Lab Animal Science Unit, Leibniz Institute for Primate research, Göttingen, Germany
| | - Rupamanjari Majumder
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Germany
| | - Stefan Luther
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Göttingen, Germany
- Institute for the Dynamics of Complex Systems, Göttingen University, Germany
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Xia YX, Xie LH, He YJ, Pan JT, Panfilov AV, Zhang H. Numerical study of the drift of scroll waves by optical feedback in cardiac tissue. Phys Rev E 2023; 108:064406. [PMID: 38243456 DOI: 10.1103/physreve.108.064406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 11/16/2023] [Indexed: 01/21/2024]
Abstract
Nonlinear waves were found in various types of physical, chemical, and biological excitable media, e.g., in heart muscle. They can form three-dimensional (3D) vortices, called scroll waves, that are of particular significance in the heart, as they underlie lethal cardiac arrhythmias. Thus controlling the behavior of scroll waves is interesting and important. Recently, the optical feedback control procedure for two-dimensional vortices, called spiral waves, was developed. It can induce directed linear drift of spiral waves in optogenetically modified cardiac tissue. However, the extension of this methodology to 3D scroll waves is nontrivial, as optogenetic signals only penetrate close to the surface of cardiac tissue. Here we present a study of this extension in a two-variable reaction-diffusion model and in a detailed model of cardiac tissue. We show that the success of the control procedure is determined by the tension of the scroll wave filament. In tissue with positive filament tension the control procedure works in all cases. However, in the case of negative filament tension for a sufficiently large medium, instabilities occur and make drift and control of scroll waves impossible. Because in normal cardiac tissue the filament tension is assumed to be positive, we conclude that the proposed optical feedback scheme can be a robust method in inducing the linear drift of scroll waves that can control their positions in cardiac tissue.
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Affiliation(s)
- Yuan-Xun Xia
- Zhejiang Institute of Modern Physics, School of Physics, Zhejiang University, Hangzhou 310058, China
| | - Ling-Hao Xie
- Zhejiang Institute of Modern Physics, School of Physics, Zhejiang University, Hangzhou 310058, China
| | - Yin-Jie He
- Information Engineering College, Zhijiang College of Zhejiang University of Technology, Shaoxing 312030, China
| | - Jun-Ting Pan
- Ocean College, Zhejiang University, Zhoushan 316021, China
| | - Alexander V Panfilov
- Department of Physics and Astronomy, Ghent University, Ghent 9000, Belgium
- Laboratory of Computational Biology and Medicine, Ural Federal University, Ekaterinburg 620002, Russia
- World-Class Research Center "Digital Biodesign and Personalized Healthcare," Sechenov University, Moscow 119146, Russia
| | - Hong Zhang
- Zhejiang Institute of Modern Physics, School of Physics, Zhejiang University, Hangzhou 310058, China
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Maciunas K, Snipas M, Kraujalis T, Kraujalienė L, Panfilov AV. The role of the Cx43/Cx45 gap junction voltage gating on wave propagation and arrhythmogenic activity in cardiac tissue. Sci Rep 2023; 13:14863. [PMID: 37684404 PMCID: PMC10491658 DOI: 10.1038/s41598-023-41796-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 08/31/2023] [Indexed: 09/10/2023] Open
Abstract
Gap junctions (GJs) formed of connexin (Cx) protein are the main conduits of electrical signals in the heart. Studies indicate that the transitional zone of the atrioventricular (AV) node contains heterotypic Cx43/Cx45 GJ channels which are highly sensitive to transjunctional voltage (Vj). To investigate the putative role of Vj gating of Cx43/Cx45 channels, we performed electrophysiological recordings in cell cultures and developed a novel mathematical/computational model which, for the first time, combines GJ channel Vj gating with a model of membrane excitability to simulate a spread of electrical pulses in 2D. Our simulation and electrophysiological data show that Vj transients during the spread of cardiac excitation can significantly affect the junctional conductance (gj) of Cx43/Cx45 GJs in a direction- and frequency-dependent manner. Subsequent simulation data indicate that such pulse-rate-dependent regulation of gj may have a physiological role in delaying impulse propagation through the AV node. We have also considered the putative role of the Cx43/Cx45 channel gating during pathological impulse propagation. Our simulation data show that Vj gating-induced changes in gj can cause the drift and subsequent termination of spiral waves of excitation. As a result, the development of fibrillation-like processes was significantly reduced in 2D clusters, which contained Vj-sensitive Cx43/Cx45 channels.
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Affiliation(s)
- Kestutis Maciunas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Mindaugas Snipas
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
- Department of Mathematical Modelling, Kaunas University of Technology, Kaunas, Lithuania.
| | - Tadas Kraujalis
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Applied Informatics, Kaunas University of Technology, Kaunas, Lithuania
| | - Lina Kraujalienė
- Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Alexander V Panfilov
- Department of Physics and Astronomy, Ghent University, Ghent, Belgium
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
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5
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Li TC, Zhong W, Ai BQ, Zhu WJ, Li BW, Panfilov AV, Dierckx H. Reordering and synchronization of electrical turbulence in cardiac tissue through global and partial optogenetical illumination. Phys Rev E 2023; 108:034218. [PMID: 37849154 DOI: 10.1103/physreve.108.034218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 09/06/2023] [Indexed: 10/19/2023]
Abstract
Electrical turbulence in the heart is considered the culprit of cardiac disease, including the fatal ventricular fibrillation. Optogenetics is an emerging technology that has the capability to produce action potentials of cardiomyocytes to affect the electric wave propagation in cardiac tissue, thereby possessing the potential to control the turbulence, by shining a rotating spiral pattern onto the tissue. In this paper, we present a method to reorder and synchronize electrical turbulence through optogenetics. A generic two-variable reaction-diffusion model and a simplified three-variable ionic cardiac model are used. We discuss cases involving either global or partial illumination.
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Affiliation(s)
- Teng-Chao Li
- School of Physics, Hangzhou Normal University, Hangzhou 311121, China and School of Physics and Telecommunication Engineering, South China Normal University, Guangzhou 510006, China
| | - Wei Zhong
- School of Physics and Telecommunication Engineering, South China Normal University, Guangzhou 510006, China
| | - Bao-Quan Ai
- School of Physics and Telecommunication Engineering, South China Normal University, Guangzhou 510006, China
| | - Wei-Jing Zhu
- School of Photoelectric Engineering, Guangdong Polytechnic Normal University, Guangzhou 510665, China
| | - Bing-Wei Li
- School of Physics, Hangzhou Normal University, Hangzhou 311121, China
| | - Alexander V Panfilov
- Ural Federal University, Biomed Laboratory, 620002 Ekaterinburg, Russia; Department of Physics and Astronomy, Ghent University, B-9000 Ghent, Belgium; and World-Class Research Center "Digital biodesign and personalized healthcare", I.M. Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Hans Dierckx
- KU Leuven Campus Kortrijk-Kulak, Department of Mathematics, Etienne Sabbelaan 53 bus 7657, 8500 Kortrijk, Belgium and iSi Health - KU Leuven Institute of Physics-based Modeling for In Silico Health, KU Leuven, Belgium
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Nizamieva AA, Kalita IY, Slotvitsky MM, Berezhnoy AK, Shubina NS, Frolova SR, Tsvelaya VA, Agladze KI. Conduction of excitation waves and reentry drift on cardiac tissue with simulated photocontrol-varied excitability. CHAOS (WOODBURY, N.Y.) 2023; 33:023112. [PMID: 36859193 DOI: 10.1063/5.0122273] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
The development of new approaches to suppressing cardiac arrhythmias requires a deep understanding of spiral wave dynamics. The study of spiral waves is possible in model systems, for example, in a monolayer of cardiomyocytes. A promising way to control cardiac excitability in vitro is the noninvasive photocontrol of cell excitability mediated by light-sensitive azobenzene derivatives, such as azobenzene trimethylammonium bromide (AzoTAB). The trans-isomer of AzoTAB suppresses spontaneous activity and excitation propagation speed, whereas the cis isomer has no detectable effect on the electrical properties of cardiomyocyte monolayers; cis isomerization occurs under the action of near ultraviolet (UV) light, and reverse isomerization occurs when exposed to blue light. Thus, AzoTAB makes it possible to create patterns of excitability in conductive tissue. Here, we investigate the effect of a simulated excitability gradient in cardiac cell culture on the behavior and termination of reentry waves. Experimental data indicate a displacement of the reentry wave, predominantly in the direction of lower excitability. However, both shifts in the direction of higher excitability and shift absence were also observed. To explain this effect, we reproduced these experiments in a computer model. Computer simulations showed that the explanation of the mechanism of observed drift to a lower excitability area requires not only a change in excitability coefficients (ion currents) but also a change in the diffusion coefficient; this may be the effect of the substance on intercellular connections. In addition, it was found that the drift direction depended on the observation time due to the meandering of the spiral wave. Thus, we experimentally proved the possibility of noninvasive photocontrol and termination of spiral waves with a mechanistic explanation in computer models.
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Affiliation(s)
- A A Nizamieva
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
| | - I Y Kalita
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
| | - M M Slotvitsky
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
| | - A K Berezhnoy
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
| | - N S Shubina
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
| | - S R Frolova
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
| | - V A Tsvelaya
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
| | - K I Agladze
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, Dolgoprudny 141700, Russian Federation
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