Key result
High-frequency overdrive pacing eliminates simulated ventricular spiral waves at specific stimulation frequencies.
Why the study?
Abnormal wave propagation, such as spiral waves, can lead to sudden cardiac arrest, prompting investigation into their dynamics under negative filament tension and elimination via high-frequency pacing.
Does high-frequency overdrive pacing eliminate spiral waves in a left ventricular computational model?
Does high-frequency overdrive pacing eliminate spiral waves in a left ventricular computational model?
Computational modeling demonstrates that high-frequency overdrive pacing can successfully eliminate dangerous spiral waves associated with negative filament tension, providing theoretical support for antitachycardia pacing.
Provides mechanistic insight into pacing for spiral wave termination; should not yet alter clinical practice pending experimental confirmation.
Nonlinear waves of electrical excitation initiate cardiac contraction. Abnormal wave propagation in the heart, e.g., spiral waves, can lead to sudden cardiac arrest. This study analyzed the dynamics of spiral waves under the influence of an instability called negative filament tension, and examined how the spiral waves can be eliminated through high-frequency pacing. A generic anatomical model of the left ventricle of the human heart and the Aliev-Panfilov model for cardiac tissue were used. The study showed that the source of such arrhythmia is elongated filaments with lengths that can be 10-20 times greater than the characteristic thickness of the heart wall. In anisotropic tissue, the filament elongated before it was annihilated at the base of the heart. The spiral waves were eliminated through overdrive pacing with stimulation periods from 0.8 to 0.95 relative to the spiral wave period. The minimum time for the expulsion was about 10 s.
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Pravdin et al. (2021) studied Cardiac arrhythmia (spiral waves). High-frequency overdrive pacing vs. Unperturbed scroll waves (no pacing) was evaluated on Elimination of spiral waves (scroll waves). High-frequency overdrive pacing eliminated spiral waves driven by negative filament tension in a computational left ventricle model when stimulation periods were 0.8 to 0.95 relative to the spiral wave period.
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