An adaptive nonlinear-dynamical control technique successfully terminated pacing-induced period-2 atrioventricular-nodal conduction alternans in 96% (52 of 54) of attempts in five patients.
Do nonlinear-dynamical control techniques terminate pacing-induced period-2 atrioventricular-nodal conduction alternans in humans?
Nonlinear-dynamical control techniques are clinically feasible for modulating human cardiac electrophysiological dynamics, providing a foundation for treating complex arrhythmias.
Nonlinear-dynamical control techniques, also known as chaos control, have been used with great success to control a wide range of physical systems. Such techniques have been used to control the behavior of in vitro excitable biological tissue, suggesting their potential for clinical utility. However, the feasibility of using such techniques to control physiological processes has not been demonstrated in humans. Here we show that nonlinear-dynamical control can modulate human cardiac electrophysiological dynamics by rapidly stabilizing an unstable target rhythm. Specifically, in 52/54 control attempts in five patients, we successfully terminated pacing-induced period-2 atrioventricular-nodal conduction alternans by stabilizing the underlying unstable steady-state conduction. This proof-of-concept demonstration shows that nonlinear-dynamical control techniques are clinically feasible and provides a foundation for developing such techniques for more complex forms of clinical arrhythmia.
Christini et al. (Tue,) conducted a other in Atrioventricular (AV) nodal conduction alternans (n=5). Adaptive nonlinear-dynamical control technique (chaos control) vs. Uncontrolled alternans was evaluated on Termination of pacing-induced period-2 atrioventricular-nodal conduction alternans. An adaptive nonlinear-dynamical control technique successfully terminated pacing-induced period-2 atrioventricular-nodal conduction alternans in 96% (52 of 54) of attempts in five patients.