Progress toward controlling in vivo fibrillating sheep atria using a nonlinear-dynamics-based closed-loop feedback method

We describe preliminary experiments on controlling in vivo atrial fibrillation using a closed-loop feedback protocol that measures the dynamics of the right atrium at a single spatial location and applies control perturbations at a single spatial location. This study allows investigation of control of cardiac dynamics in a preparation that is physiologically close to an in vivo human heart. The spatial-temporal response of the fibrillating sheep atrium is measured using a multi-channel electronic recording system to assess the control effectiveness. In an attempt to suppress fibrillation, we implement a scheme that paces occasionally the cardiac muscle with small shocks. When successful, the inter-activation time interval is the same and electrical stimuli are only applied when the controller senses that the dynamics are beginning to depart from the desired periodic rhythm. The shock timing is adjusted in real time using a control algorithm that attempts to synchronize the most recently measured inter-activation interval with the previous interval by inducing an activation at a time projected by the algorithm. The scheme is "single-sided" in that it can only shorten the inter-activation time but not lengthen it. Using probability distributions of the inter-activation time intervals, we find that the feedback protocol is not effective in regularizing the dynamics. One possible reason for the less-than-successful results is that the controller often attempts to stimulate the tissue while it is still in the refractory state and hence it does not induce an activation.