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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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2
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Portero V, Deng S, Boink GJJ, Zhang GQ, de Vries A, Pijnappels DA. Optoelectronic control of cardiac rhythm: Toward shock-free ambulatory cardioversion of atrial fibrillation. J Intern Med 2024; 295:126-145. [PMID: 37964404 DOI: 10.1111/joim.13744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, progressive in nature, and known to have a negative impact on mortality, morbidity, and quality of life. Patients requiring acute termination of AF to restore sinus rhythm are subjected to electrical cardioversion, which requires sedation and therefore hospitalization due to pain resulting from the electrical shocks. However, considering the progressive nature of AF and its detrimental effects, there is a clear need for acute out-of-hospital (i.e., ambulatory) cardioversion of AF. In the search for shock-free cardioversion methods to realize such ambulatory therapy, a method referred to as optogenetics has been put forward. Optogenetics enables optical control over the electrical activity of cardiomyocytes by targeted expression of light-activated ion channels or pumps and may therefore serve as a means for cardioversion. First proof-of-principle for such light-induced cardioversion came from in vitro studies, proving optogenetic AF termination to be very effective. Later, these results were confirmed in various rodent models of AF using different transgenes, illumination methods, and protocols, whereas computational studies in the human heart provided additional translational insight. Based on these results and fueled by recent advances in molecular biology, gene therapy, and optoelectronic engineering, a basis is now being formed to explore clinical translations of optoelectronic control of cardiac rhythm. In this review, we discuss the current literature regarding optogenetic cardioversion of AF to restore normal rhythm in a shock-free manner. Moreover, key translational steps will be discussed, both from a biological and technological point of view, to outline a path toward realizing acute shock-free ambulatory termination of AF.
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Affiliation(s)
- Vincent Portero
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Shanliang Deng
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Department of Microelectronics, Delft University of Technology, Delft, The Netherlands
| | - Gerard J J Boink
- Department of Medical Biology, Department of Cardiology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Guo Qi Zhang
- Department of Microelectronics, Delft University of Technology, Delft, The Netherlands
| | - Antoine de Vries
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - Daniël A Pijnappels
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
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3
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Tolstik E, Lehnart SE, Soeller C, Lorenz K, Sacconi L. Cardiac multiscale bioimaging: from nano- through micro- to mesoscales. Trends Biotechnol 2024; 42:212-227. [PMID: 37806897 DOI: 10.1016/j.tibtech.2023.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 10/10/2023]
Abstract
Cardiac multiscale bioimaging is an emerging field that aims to provide a comprehensive understanding of the heart and its functions at various levels, from the molecular to the entire organ. It combines both physiologically and clinically relevant dimensions: from nano- and micrometer resolution imaging based on vibrational spectroscopy and high-resolution microscopy to assess molecular processes in cardiac cells and myocardial tissue, to mesoscale structural investigations to improve the understanding of cardiac (patho)physiology. Tailored super-resolution deep microscopy with advanced proteomic methods and hands-on experience are thus strategically combined to improve the quality of cardiovascular research and support future medical decision-making by gaining additional biomolecular information for translational and diagnostic applications.
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Affiliation(s)
- Elen Tolstik
- Department of Cardiovascular Pharmacology, Translational Research, Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V. Bunsen-Kirchhoff-Strasse 11, 44139 Dortmund, Germany.
| | - Stephan E Lehnart
- Department of Cardiology and Pneumology, Cellular Biophysics and Translational Cardiology Section, Heart Research Center Göttingen, University Medical Center Göttingen, Georg-August University Göttingen, Robert-Koch-Strasse 42a, 37075 Göttingen, Germany; Cluster of Excellence Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells (MBExC2067), University of Göttingen, 37073 Göttingen, Germany; Collaborative Research Center SFB1190 Compartmental Gates and Contact Sites in Cells, University of Göttingen, 37073 Göttingen, Germany
| | - Christian Soeller
- Department of Physiology, University of Bern, Bühlplatz 5, 3012 Bern, Switzerland
| | - Kristina Lorenz
- Department of Cardiovascular Pharmacology, Translational Research, Leibniz-Institut für Analytische Wissenschaften - ISAS - e.V. Bunsen-Kirchhoff-Strasse 11, 44139 Dortmund, Germany; Institute of Pharmacology and Toxicology, University of Würzburg, Versbacher Strasse 9, 97078 Würzburg, Germany
| | - Leonardo Sacconi
- Institute of Clinical Physiology, National Research Council, Rome, Italy; Institute for Experimental Cardiovascular Medicine, University Freiburg, Elsässer Strasse 2q, 79110 Freiburg, Germany.
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4
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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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5
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Ohnemus S, Vierock J, Schneider-Warme F. Optogenetics meets physiology. Pflugers Arch 2023; 475:1369-1373. [PMID: 38047968 PMCID: PMC10730680 DOI: 10.1007/s00424-023-02887-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/05/2023]
Affiliation(s)
- Sophia Ohnemus
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Spemann Graduate School of Biology and Medicine (SGBM), University of Freiburg, Freiburg, Germany
- Faculty of Mathematics and Physics, University of Freiburg, Freiburg, Germany
| | | | - Franziska Schneider-Warme
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
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6
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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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7
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Pyari G, Bansal H, Roy S. Optogenetically mediated large volume suppression and synchronized excitation of human ventricular cardiomyocytes. Pflugers Arch 2023; 475:1479-1503. [PMID: 37415050 DOI: 10.1007/s00424-023-02831-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 07/08/2023]
Abstract
A major challenge in cardiac optogenetics is to have minimally invasive large volume excitation and suppression for effective cardioversion and treatment of tachycardia. It is important to study the effect of light attenuation on the electrical activity of cells in in vivo cardiac optogenetic experiments. In this computational study, we present a detailed analysis of the effect of light attenuation in different channelrhodopsins (ChRs)-expressing human ventricular cardiomyocytes. The study shows that sustained illumination from the myocardium surface used for suppression, simultaneously results in spurious excitation in deeper tissue regions. Tissue depths of suppressed and excited regions have been determined for different opsin expression levels. It is shown that increasing the expression level by 5-fold enhances the depth of suppressed tissue from 2.24 to 3.73 mm with ChR2(H134R) (ChR2 with a single point mutation at position H134), 3.78 to 5.12 mm with GtACR1 (anion-conducting ChR from cryptophyte algae Guillardia theta) and 6.63 to 9.31 mm with ChRmine (a marine opsin gene from Tiarina fusus). Light attenuation also results in desynchrony in action potentials in different tissue regions under pulsed illumination. It is further shown that gradient-opsin expression not only enables suppression up to the same level of tissue depth but also enables synchronized excitation under pulsed illumination. The study is important for the effective treatment of tachycardia and cardiac pacing and for extending the scale of cardiac optogenetics.
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Affiliation(s)
- Gur Pyari
- Department of Physics and Computer Science, Dayalbagh Educational Institute, Agra, 282005, India
| | - Himanshu Bansal
- Department of Physics and Computer Science, Dayalbagh Educational Institute, Agra, 282005, India
| | - Sukhdev Roy
- Department of Physics and Computer Science, Dayalbagh Educational Institute, Agra, 282005, India.
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8
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Hussaini S, Majumder R, Krinski V, Luther S. In silico optical modulation of spiral wave trajectories in cardiac tissue. Pflugers Arch 2023; 475:1453-1461. [PMID: 38095694 PMCID: PMC10730633 DOI: 10.1007/s00424-023-02889-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/21/2023]
Abstract
Life-threatening cardiac arrhythmias such as ventricular tachycardia and fibrillation are common precursors to sudden cardiac death. They are associated with the occurrence of abnormal electrical spiral waves in the heart that rotate at a high frequency. In severe cases, arrhythmias are combated with a clinical method called defibrillation, which involves administering a single global high-voltage shock to the heart to reset all its activity and restore sinus rhythm. Despite its high efficiency in controlling arrhythmias, defibrillation is associated with several negative side effects that render the method suboptimal. The best approach to optimize this therapeutic technique is to deepen our understanding of the dynamics of spiral waves. Here, we use computational cardiac optogenetics to study and control the dynamics of a single spiral wave in a two-dimensional, electrophysiologically detailed, light-sensitive model of a mouse ventricle. First, we illuminate the domain globally by applying a sequence of periodic optical pulses with different frequencies in the sub-threshold regime where no excitation wave is induced. In doing so, we obtain epicycloidal, hypocycloidal, and resonant drift trajectories of the spiral wave core. Then, to effectively control the wave dynamics, we use a method called resonant feedback pacing. In this approach, each global optical pulse is applied when the measuring electrode positioned on the domain registers a predefined value of the membrane voltage. This enables us to steer the spiral wave in a desired direction determined by the position of the electrode. Our study thus provides valuable mechanistic insights into the success or failure of global optical stimulation in executing efficient arrhythmia control.
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Affiliation(s)
- Sayedeh Hussaini
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Niedersachsen, Germany.
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Am Fassberg, 37077, Göttingen, Niedersachsen, Germany.
| | - Rupamanjari Majumder
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Niedersachsen, Germany
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Am Fassberg, 37077, Göttingen, Niedersachsen, Germany
| | - Valentin Krinski
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Am Fassberg, 37077, Göttingen, Niedersachsen, Germany
| | - Stefan Luther
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Niedersachsen, Germany.
- Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Am Fassberg, 37077, Göttingen, Niedersachsen, Germany.
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9
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Junge S, Ricci Signorini ME, Al Masri M, Gülink J, Brüning H, Kasperek L, Szepes M, Bakar M, Gruh I, Heisterkamp A, Torres-Mapa ML. A micro-LED array based platform for spatio-temporal optogenetic control of various cardiac models. Sci Rep 2023; 13:19490. [PMID: 37945622 PMCID: PMC10636122 DOI: 10.1038/s41598-023-46149-1] [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: 08/10/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
Optogenetics relies on dynamic spatial and temporal control of light to address emerging fundamental and therapeutic questions in cardiac research. In this work, a compact micro-LED array, consisting of 16 × 16 pixels, is incorporated in a widefield fluorescence microscope for controlled light stimulation. We describe the optical design of the system that allows the micro-LED array to fully cover the field of view regardless of the imaging objective used. Various multicellular cardiac models are used in the experiments such as channelrhodopsin-2 expressing aggregates of cardiomyocytes, termed cardiac bodies, and bioartificial cardiac tissues derived from human induced pluripotent stem cells. The pacing efficiencies of the cardiac bodies and bioartificial cardiac tissues were characterized as a function of illumination time, number of switched-on pixels and frequency of stimulation. To demonstrate dynamic stimulation, steering of calcium waves in HL-1 cell monolayer expressing channelrhodopsin-2 was performed by applying different configurations of patterned light. This work shows that micro-LED arrays are powerful light sources for optogenetic control of contraction and calcium waves in cardiac monolayers, multicellular bodies as well as three-dimensional artificial cardiac tissues.
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Affiliation(s)
- Sebastian Junge
- Institute of Quantum Optics, Gottfried Wilhelm Leibniz University, 30167, Hannover, Germany
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625, Hannover, Germany
| | - Maria Elena Ricci Signorini
- Department of Cardiac, Thoracic-, Transplantation and Vascular Surgery, Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Hannover Medical School, 30625, Hannover, Germany
| | - Masa Al Masri
- Institute of Quantum Optics, Gottfried Wilhelm Leibniz University, 30167, Hannover, Germany
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625, Hannover, Germany
| | - Jan Gülink
- QubeDot GmbH, Wilhelmsgarten 3, 38100, Brunswick, Germany
| | - Heiko Brüning
- QubeDot GmbH, Wilhelmsgarten 3, 38100, Brunswick, Germany
| | - Leon Kasperek
- Institute of Quantum Optics, Gottfried Wilhelm Leibniz University, 30167, Hannover, Germany
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625, Hannover, Germany
| | - Monika Szepes
- Department of Cardiac, Thoracic-, Transplantation and Vascular Surgery, Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Hannover Medical School, 30625, Hannover, Germany
| | - Mine Bakar
- Department of Cardiac, Thoracic-, Transplantation and Vascular Surgery, Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Hannover Medical School, 30625, Hannover, Germany
| | - Ina Gruh
- Department of Cardiac, Thoracic-, Transplantation and Vascular Surgery, Leibniz Research Laboratories for Biotechnology and Artificial Organs (LEBAO), Hannover Medical School, 30625, Hannover, Germany
| | - Alexander Heisterkamp
- Institute of Quantum Optics, Gottfried Wilhelm Leibniz University, 30167, Hannover, Germany
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625, Hannover, Germany
| | - Maria Leilani Torres-Mapa
- Institute of Quantum Optics, Gottfried Wilhelm Leibniz University, 30167, Hannover, Germany.
- Lower Saxony Centre for Biomedical Engineering, Implant Research and Development (NIFE), 30625, Hannover, Germany.
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10
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Aitova A, Berezhnoy A, Tsvelaya V, Gusev O, Lyundup A, Efimov AE, Agapov I, Agladze K. Biomimetic Cardiac Tissue Models for In Vitro Arrhythmia Studies. Biomimetics (Basel) 2023; 8:487. [PMID: 37887618 PMCID: PMC10604593 DOI: 10.3390/biomimetics8060487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/26/2023] [Accepted: 10/03/2023] [Indexed: 10/28/2023] Open
Abstract
Cardiac arrhythmias are a major cause of cardiovascular mortality worldwide. Many arrhythmias are caused by reentry, a phenomenon where excitation waves circulate in the heart. Optical mapping techniques have revealed the role of reentry in arrhythmia initiation and fibrillation transition, but the underlying biophysical mechanisms are still difficult to investigate in intact hearts. Tissue engineering models of cardiac tissue can mimic the structure and function of native cardiac tissue and enable interactive observation of reentry formation and wave propagation. This review will present various approaches to constructing cardiac tissue models for reentry studies, using the authors' work as examples. The review will highlight the evolution of tissue engineering designs based on different substrates, cell types, and structural parameters. A new approach using polymer materials and cellular reprogramming to create biomimetic cardiac tissues will be introduced. The review will also show how computational modeling of cardiac tissue can complement experimental data and how such models can be applied in the biomimetics of cardiac tissue.
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Affiliation(s)
- Aleria Aitova
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, 141700 Dolgoprudny, Russia
- M.F. Vladimirsky Moscow Regional Clinical Research Institute, 129110 Moscow, Russia
- Almetyevsk State Oil Institute, 423450 Almetyevsk, Russia
| | - Andrey Berezhnoy
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, 141700 Dolgoprudny, Russia
- M.F. Vladimirsky Moscow Regional Clinical Research Institute, 129110 Moscow, Russia
- Almetyevsk State Oil Institute, 423450 Almetyevsk, Russia
| | - Valeriya Tsvelaya
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, 141700 Dolgoprudny, Russia
- M.F. Vladimirsky Moscow Regional Clinical Research Institute, 129110 Moscow, Russia
- Almetyevsk State Oil Institute, 423450 Almetyevsk, Russia
| | - Oleg Gusev
- Regulatory Genomics Research Center, Institute of Fundamental Medicine and Biology, Kazan Federal University, 420018 Kazan, Russia
- Life Improvement by Future Technologies (LIFT) Center, 143025 Moscow, Russia
- Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | | | - Anton E. Efimov
- Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs, Ministry of Health of the Russian Federation, 123182 Moscow, Russia
| | - Igor Agapov
- Academician V.I. Shumakov National Medical Research Center of Transplantology and Artificial Organs, Ministry of Health of the Russian Federation, 123182 Moscow, Russia
| | - Konstantin Agladze
- Laboratory of Experimental and Cellular Medicine, Moscow Institute of Physics and Technology, 141700 Dolgoprudny, Russia
- M.F. Vladimirsky Moscow Regional Clinical Research Institute, 129110 Moscow, Russia
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11
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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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12
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Nyns ECA, Portero V, Deng S, Jin T, Harlaar N, Bart CI, van Brakel TJ, Palmen M, Hjortnaes J, Ramkisoensing AA, Zhang GQ, Poelma RH, Ördög B, de Vries AAF, Pijnappels DA. Light transmittance in human atrial tissue and transthoracic illumination in rats support translatability of optogenetic cardioversion of atrial fibrillation. J Intern Med 2023; 294:347-357. [PMID: 37340835 DOI: 10.1111/joim.13654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Optogenetics could offer a solution to the current lack of an ambulatory method for the rapid automated cardioversion of atrial fibrillation (AF), but key translational aspects remain to be studied. OBJECTIVE To investigate whether optogenetic cardioversion of AF is effective in the aged heart and whether sufficient light penetrates the human atrial wall. METHODS Atria of adult and aged rats were optogenetically modified to express light-gated ion channels (i.e., red-activatable channelrhodopsin), followed by AF induction and atrial illumination to determine the effectivity of optogenetic cardioversion. The irradiance level was determined by light transmittance measurements on human atrial tissue. RESULTS AF could be effectively terminated in the remodeled atria of aged rats (97%, n = 6). Subsequently, ex vivo experiments using human atrial auricles demonstrated that 565-nm light pulses at an intensity of 25 mW/mm2 achieved the complete penetration of the atrial wall. Applying such irradiation onto the chest of adult rats resulted in transthoracic atrial illumination as evidenced by the optogenetic cardioversion of AF (90%, n = 4). CONCLUSION Transthoracic optogenetic cardioversion of AF is effective in the aged rat heart using irradiation levels compatible with human atrial transmural light penetration.
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Affiliation(s)
- Emile C A Nyns
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Vincent Portero
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Shanliang Deng
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Tianyi Jin
- Department of Microelectronics, Delft University of Technology, Delft, the Netherlands
| | - Niels Harlaar
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Cindy I Bart
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | | | - Meindert Palmen
- Department of Cardiothoracic Surgery, LUMC, Leiden, the Netherlands
| | - Jesper Hjortnaes
- Department of Cardiothoracic Surgery, LUMC, Leiden, the Netherlands
| | - Arti A Ramkisoensing
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Guo Qi Zhang
- Department of Microelectronics, Delft University of Technology, Delft, the Netherlands
| | - René H Poelma
- Department of Microelectronics, Delft University of Technology, Delft, the Netherlands
| | - Balázs Ördög
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Antoine A F de Vries
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Daniël A Pijnappels
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
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13
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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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14
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Ochs AR, Boyle PM. Optogenetic Modulation of Arrhythmia Triggers: Proof-of-Concept from Computational Modeling. Cell Mol Bioeng 2023; 16:243-259. [PMID: 37810996 PMCID: PMC10550900 DOI: 10.1007/s12195-023-00781-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/14/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Early afterdepolarizations (EADs) are secondary voltage depolarizations associated with reduced repolarization reserve (RRR) that can trigger lethal arrhythmias. Relating EADs to triggered activity is difficult to study, so the ability to suppress or provoke EADs would be experimentally useful. Here, we use computational simulations to assess the feasibility of subthreshold optogenetic stimulation modulating the propensity for EADs (cell-scale) and EAD-associated ectopic beats (organ-scale). Methods We modified a ventricular ionic model by reducing rapid delayed rectifier potassium (0.25-0.1 × baseline) and increasing L-type calcium (1.0-3.5 × baseline) currents to create RRR conditions with varying severity. We ran simulations in models of single cardiomyocytes and left ventricles from post-myocardial infarction patient MRI scans. Optogenetic stimulation was simulated using either ChR2 (depolarizing) or GtACR1 (repolarizing) opsins. Results In cell-scale simulations without illumination, EADs were seen for 164 of 416 RRR conditions. Subthreshold stimulation of GtACR1 reduced EAD incidence by up to 84.8% (25/416 RRR conditions; 0.1 μW/mm2); in contrast, subthreshold ChR2 excitation increased EAD incidence by up to 136.6% (388/416 RRR conditions; 50 μW/mm2). At the organ scale, we assumed simultaneous, uniform illumination of the epicardial and endocardial surfaces. GtACR1-mediated suppression (10-50 μW/mm2) and ChR2-mediated unmasking (50-100 μW/mm2) of EAD-associated ectopic beats were feasible in three distinct ventricular models. Conclusions Our findings suggest that optogenetics could be used to silence or provoke both EADs and EAD-associated ectopic beats. Validation in animal models could lead to exciting new experimental regimes and potentially to novel anti-arrhythmia treatments. Supplementary Information The online version contains supplementary material available at 10.1007/s12195-023-00781-z.
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Affiliation(s)
- Alexander R. Ochs
- Department of Bioengineering, UW Bioengineering, University of Washington, 3720 15th Ave NE N107, UW Mailbox 355061, Seattle, WA 98195 USA
| | - Patrick M. Boyle
- Department of Bioengineering, UW Bioengineering, University of Washington, 3720 15th Ave NE N107, UW Mailbox 355061, Seattle, WA 98195 USA
- Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA USA
- Center for Cardiovascular Biology, University of Washington, Seattle, WA USA
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15
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Aron M, Lilienkamp T, Luther S, Parlitz U. Optimising low-energy defibrillation in 2D cardiac tissue with a genetic algorithm. FRONTIERS IN NETWORK PHYSIOLOGY 2023; 3:1172454. [PMID: 37555132 PMCID: PMC10406519 DOI: 10.3389/fnetp.2023.1172454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/28/2023] [Indexed: 08/10/2023]
Abstract
Sequences of low-energy electrical pulses can effectively terminate ventricular fibrillation (VF) and avoid the side effects of conventional high-energy electrical defibrillation shocks, including tissue damage, traumatic pain, and worsening of prognosis. However, the systematic optimisation of sequences of low-energy pulses remains a major challenge. Using 2D simulations of homogeneous cardiac tissue and a genetic algorithm, we demonstrate the optimisation of sequences with non-uniform pulse energies and time intervals between consecutive pulses for efficient VF termination. We further identify model-dependent reductions of total pacing energy ranging from ∼4% to ∼80% compared to reference adaptive-deceleration pacing (ADP) protocols of equal success rate (100%).
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Affiliation(s)
- Marcel Aron
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen, Germany
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute for the Dynamics of Complex Systems, Georg-August-Universität Göttingen, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Thomas Lilienkamp
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Computational Physics for Life Science, Nuremberg Institute of Technology Georg Simon Ohm, Nuremberg, Germany
| | - Stefan Luther
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen, Germany
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute for the Dynamics of Complex Systems, Georg-August-Universität Göttingen, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Ulrich Parlitz
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute for the Dynamics of Complex Systems, Georg-August-Universität Göttingen, Göttingen, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
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16
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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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17
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Xia YX, Zhi XP, Li TC, Pan JT, Panfilov AV, Zhang H. Spiral wave drift under optical feedback in cardiac tissue. Phys Rev E 2022; 106:024405. [PMID: 36109896 DOI: 10.1103/physreve.106.024405] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
Spiral waves occur in various types of excitable media and their dynamics determine the spatial excitation patterns. An important type of spiral wave dynamics is drift, as it can control the position of a spiral wave or eliminate a spiral wave by forcing it to the boundary. In theoretical and experimental studies of the Belousov-Zhabotinsky reaction, it was shown that the most direct way to induce the controlled drift of spiral waves is by application of an external electric field. Mathematically such drift occurs due to the onset of additional gradient terms in the Laplacian operator describing excitable media. However, this approach does not work for cardiac excitable tissue, where an external electric field does not result in gradient terms. In this paper, we propose a method of how to induce a directed linear drift of spiral waves in cardiac tissue, which can be realized as an optical feedback control in tissue where photosensitive ion channels are expressed. We illustrate our method by using the FitzHugh-Nagumo model for cardiac tissue and the generic model of photosensitive ion channels. We show that our method works for continuous and discrete light sources and can effectively move spiral waves in cardiac tissue, or eliminate them by collisions with the boundary or with another spiral wave. We finally implement our method by using a biophysically motivated photosensitive ion channel model included to the Luo-Rudy model for cardiac cells and show that the proposed feedback control also induces directed linear drift of spiral waves in a wide range of light intensities.
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Affiliation(s)
- Yuan-Xun Xia
- Zhejiang Institute of Modern Physics, School of Physics, Zhejiang University, Hangzhou 310027, China
| | - Xin-Pei Zhi
- Zhejiang Institute of Modern Physics, School of Physics, Zhejiang University, Hangzhou 310027, China
| | - Teng-Chao Li
- School of Physics and Telecommunication Engineering, South China Normal University, Guangzhou 510006, 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 310027, China
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18
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Emiliani V, Entcheva E, Hedrich R, Hegemann P, Konrad KR, Lüscher C, Mahn M, Pan ZH, Sims RR, Vierock J, Yizhar O. Optogenetics for light control of biological systems. NATURE REVIEWS. METHODS PRIMERS 2022; 2:55. [PMID: 37933248 PMCID: PMC10627578 DOI: 10.1038/s43586-022-00136-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/30/2022] [Indexed: 11/08/2023]
Abstract
Optogenetic techniques have been developed to allow control over the activity of selected cells within a highly heterogeneous tissue, using a combination of genetic engineering and light. Optogenetics employs natural and engineered photoreceptors, mostly of microbial origin, to be genetically introduced into the cells of interest. As a result, cells that are naturally light-insensitive can be made photosensitive and addressable by illumination and precisely controllable in time and space. The selectivity of expression and subcellular targeting in the host is enabled by applying control elements such as promoters, enhancers and specific targeting sequences to the employed photoreceptor-encoding DNA. This powerful approach allows precise characterization and manipulation of cellular functions and has motivated the development of advanced optical methods for patterned photostimulation. Optogenetics has revolutionized neuroscience during the past 15 years and is primed to have a similar impact in other fields, including cardiology, cell biology and plant sciences. In this Primer, we describe the principles of optogenetics, review the most commonly used optogenetic tools, illumination approaches and scientific applications and discuss the possibilities and limitations associated with optogenetic manipulations across a wide variety of optical techniques, cells, circuits and organisms.
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Affiliation(s)
- Valentina Emiliani
- Wavefront Engineering Microscopy Group, Photonics Department, Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Emilia Entcheva
- Department of Biomedical Engineering, George Washington University, Washington, DC, USA
| | - Rainer Hedrich
- Julius-von-Sachs Institute for Biosciences, Molecular Plant Physiology and Biophysics, University of Wuerzburg, Wuerzburg, Germany
| | - Peter Hegemann
- Institute for Biology, Experimental Biophysics, Humboldt-Universitaet zu Berlin, Berlin, Germany
| | - Kai R. Konrad
- Julius-von-Sachs Institute for Biosciences, Molecular Plant Physiology and Biophysics, University of Wuerzburg, Wuerzburg, Germany
| | - Christian Lüscher
- Department of Basic Neurosciences, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Clinic of Neurology, Department of Clinical Neurosciences, Geneva University Hospital, Geneva, Switzerland
| | - Mathias Mahn
- Department of Neurobiology, Friedrich Miescher Institute for Biomedical Research, Basel, Switzerland
| | - Zhuo-Hua Pan
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ruth R. Sims
- Wavefront Engineering Microscopy Group, Photonics Department, Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Johannes Vierock
- Institute for Biology, Experimental Biophysics, Humboldt-Universitaet zu Berlin, Berlin, Germany
- Neuroscience Research Center, Charité – Universitaetsmedizin Berlin, Berlin, Germany
| | - Ofer Yizhar
- Departments of Brain Sciences and Molecular Neuroscience, Weizmann Institute of Science, Rehovot, Israel
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19
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Terminating spiral waves with a single designed stimulus: Teleportation as the mechanism for defibrillation. Proc Natl Acad Sci U S A 2022; 119:e2117568119. [PMID: 35679346 PMCID: PMC9214532 DOI: 10.1073/pnas.2117568119] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Many chemical and biological systems can sustain complex spiral wave dynamics. In the heart, spiral waves of electrical activity induce deadly arrhythmias and must be eliminated with a large, system-wide perturbation to restore a healthy rhythm. However, the high-energy shocks required for defibrillation therapies are very painful and can even damage heart tissue. In this study, we demonstrate a method for eliminating spiral waves with what should be the minimal possible stimulus required in space for termination. To do this, we show how a localized perturbation can be designed to annihilate simultaneously all spiral waves both free and bound. This identified mechanism is applicable to any excitable system and, for the heart, may lead to more efficient defibrillation strategies. We identify and demonstrate a universal mechanism for terminating spiral waves in excitable media using an established topological framework. This mechanism dictates whether high- or low-energy defibrillation shocks succeed or fail. Furthermore, this mechanism allows for the design of a single minimal stimulus capable of defibrillating, at any time, turbulent states driven by multiple spiral waves. We demonstrate this method in a variety of computational models of cardiac tissue ranging from simple to detailed human models. The theory described here shows how this mechanism underlies all successful defibrillation and can be used to further develop existing and future low-energy defibrillation strategies.
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20
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Li QH, Xia YX, Xu SX, Song Z, Pan JT, Panfilov AV, Zhang H. Control of spiral waves in optogenetically modified cardiac tissue by periodic optical stimulation. Phys Rev E 2022; 105:044210. [PMID: 35590553 DOI: 10.1103/physreve.105.044210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/30/2022] [Indexed: 06/15/2023]
Abstract
Resonant drift of nonlinear spiral waves occurs in various types of excitable media under periodic stimulation. Recently a novel methodology of optogenetics has emerged, which allows to affect excitability of cardiac cells and tissues by optical stimuli. In this paper we study if resonant drift of spiral waves in the heart can be induced by a homogeneous weak periodic optical stimulation of cardiac tissue. We use a two-variable and a detailed model of cardiac tissue and add description of depolarizing and hyperpolarizing optogenetic ionic currents. We show that weak periodic optical stimulation at a frequency equal to the natural rotation frequency of the spiral wave induces resonant drift for both depolarizing and hyperpolarizing optogenetic currents. We quantify these effects and study how the speed of the drift and its direction depend on the initial conditions. We also derive analytical formulas based on the response function theory which correctly predict the drift velocity and its trajectory. We conclude that optogenetic methodology can be used for control of spiral waves in cardiac tissue and discuss its possible applications.
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Affiliation(s)
- Qi-Hao Li
- Zhejiang Institute of Modern Physics and Department of Physics, Zhejiang University, Hangzhou 310027, China
- Department of Mathematics and Theories, Peng Cheng Laboratory, Shenzhen 518066, China
| | - Yuan-Xun Xia
- Zhejiang Institute of Modern Physics and Department of Physics, Zhejiang University, Hangzhou 310027, China
| | - Shu-Xiao Xu
- Zhejiang Institute of Modern Physics and Department of Physics, Zhejiang University, Hangzhou 310027, China
| | - Zhen Song
- Department of Mathematics and Theories, Peng Cheng Laboratory, Shenzhen 518066, 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 and Department of Physics, Zhejiang University, Hangzhou 310027, China
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21
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Diaz-Maue L, Steinebach J, Richter C. Patterned Illumination Techniques in Optogenetics: An Insight Into Decelerating Murine Hearts. Front Physiol 2022; 12:750535. [PMID: 35087413 PMCID: PMC8787046 DOI: 10.3389/fphys.2021.750535] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/02/2021] [Indexed: 11/21/2022] Open
Abstract
Much has been reported about optogenetic based cardiac arrhythmia treatment and the corresponding characterization of photostimulation parameters, but still, our capacity to interact with the underlying spatiotemporal excitation patterns relies mainly on electrical and/or pharmacological approaches. However, these well-established treatments have always been an object of somehow heated discussions. Though being acutely life-saving, they often come with potential side-effects leading to a decreased functionality of the complex cardiac system. Recent optogenetic studies showed the feasibility of the usage of photostimulation as a defibrillation method with comparatively high success rates. Although, these studies mainly concentrated on the description as well as on the comparison of single photodefibrillation approaches, such as locally focused light application and global illumination, less effort was spent on the description of excitation patterns during actual photostimulation. In this study, the authors implemented a multi-site photodefibrillation technique in combination with Multi-Lead electrocardiograms (ECGs). The technical connection of real-time heart rhythm measurements and the arrhythmia counteracting light control provides a further step toward automated arrhythmia classification, which can lead to adaptive photodefibrillation methods. In order to show the power effectiveness of the new approach, transgenic murine hearts expressing channelrhodopsin-2 ex vivo were investigated using circumferential micro-LED and ECG arrays. Thus, combining the best of two methods by giving the possibility to illuminate either locally or globally with differing pulse parameters. The optical technique presented here addresses a number of challenges of technical cardiac optogenetics and is discussed in the context of arrhythmic development during photostimulation.
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Affiliation(s)
- Laura Diaz-Maue
- Department of Research Electronics, Max-Planck-Institute for Dynamics and Self-Organization, Göttingen, Germany.,Biomedical Physics Research Group, Max-Planck-Institute for Dynamics and Self-Organization, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK e., V.), Göttingen, Germany
| | - Janna Steinebach
- Biomedical Physics Research Group, Max-Planck-Institute for Dynamics and Self-Organization, Göttingen, Germany
| | - Claudia Richter
- German Center for Cardiovascular Research (DZHK e., V.), Göttingen, Germany.,Laboratory Animal Science Unit, German Primate Center, Leibniz-Institute for Primate Research, Göttingen, Germany
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22
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Li TC, Zhong W, Ai BQ, Panfilov AV, Dierckx H. Control of the chirality of spiral waves and recreation of spatial excitation patterns through optogenetics. Phys Rev E 2022; 105:014214. [PMID: 35193299 DOI: 10.1103/physreve.105.014214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
Spiral waves lead to dangerous arrhythmias in the cardiac system. In 2015 Burton et al. demonstrated the reversal of the spiral wave chirality through the rotating spiral-shaped illumination on the optogenetically modified cardiac monolayers. We show that this process entails the recreation of a spiral wave. We show how this methodology can be used to control and create the desired spatial excitation pattern. We found that the control is sensitive to the area of illuminated region but independent of the phase difference of the existing spiral wave and the applied spiral-shaped light. We also discovered that our methodology can temporarily resynchronize a turbulent system. The results offer numerical evidence for the control of spatial pattern in biological excitable systems with optogenetics.
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Affiliation(s)
- Teng-Chao Li
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials and School of Physics and Telecommunication Engineering, South China Normal University, Guangzhou 510006, China and Guangdong-Hong Kong Joint Laboratory of Quantum Matter, Frontier Research Institute for Physics, South China Normal University, Guangzhou 510006, China
| | - Wei Zhong
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials and School of Physics and Telecommunication Engineering, South China Normal University, Guangzhou 510006, China and Guangdong-Hong Kong Joint Laboratory of Quantum Matter, Frontier Research Institute for Physics, South China Normal University, Guangzhou 510006, China
| | - Bao-Quan Ai
- Guangdong Provincial Key Laboratory of Quantum Engineering and Quantum Materials and School of Physics and Telecommunication Engineering, South China Normal University, Guangzhou 510006, China and Guangdong-Hong Kong Joint Laboratory of Quantum Matter, Frontier Research Institute for Physics, South China Normal University, Guangzhou 510006, China
| | - Alexander V Panfilov
- Ural Federal University, Biomed Laboratory, 620002 Ekaterinburg, Russia; Ghent University, 9000 Ghent, Belgium; and World-Class Research Center "Digital Biodesign and Personalized Healthcare," I. M. Sechenov First Moscow State Medical University, 119146 Moscow, Russia
| | - Hans Dierckx
- KU Leuven Campus Kortrijk-Kulak, Department of Mathematics, Etienne Sabbelaan 53, 8500 Kortrijk, Belgium and iSi Health - KU Leuven Institute of Physics-based Modeling for In Silico Health, KU Leuven, Belgium
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23
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Optogenetic manipulation of cardiac electrical dynamics using sub-threshold illumination: dissecting the role of cardiac alternans in terminating rapid rhythms. Basic Res Cardiol 2022; 117:25. [PMID: 35488105 PMCID: PMC9054908 DOI: 10.1007/s00395-022-00933-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 04/01/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023]
Abstract
Cardiac action potential (AP) shape and propagation are regulated by several key dynamic factors such as ion channel recovery and intracellular Ca2+ cycling. Experimental methods for manipulating AP electrical dynamics commonly use ion channel inhibitors that lack spatial and temporal specificity. In this work, we propose an approach based on optogenetics to manipulate cardiac electrical activity employing a light-modulated depolarizing current with intensities that are too low to elicit APs (sub-threshold illumination), but are sufficient to fine-tune AP electrical dynamics. We investigated the effects of sub-threshold illumination in isolated cardiomyocytes and whole hearts by using transgenic mice constitutively expressing a light-gated ion channel (channelrhodopsin-2, ChR2). We find that ChR2-mediated depolarizing current prolongs APs and reduces conduction velocity (CV) in a space-selective and reversible manner. Sub-threshold manipulation also affects the dynamics of cardiac electrical activity, increasing the magnitude of cardiac alternans. We used an optical system that uses real-time feedback control to generate re-entrant circuits with user-defined cycle lengths to explore the role of cardiac alternans in spontaneous termination of ventricular tachycardias (VTs). We demonstrate that VT stability significantly decreases during sub-threshold illumination primarily due to an increase in the amplitude of electrical oscillations, which implies that cardiac alternans may be beneficial in the context of self-termination of VT.
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24
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Müllenbroich MC, Kelly A, Acker C, Bub G, Bruegmann T, Di Bona A, Entcheva E, Ferrantini C, Kohl P, Lehnart SE, Mongillo M, Parmeggiani C, Richter C, Sasse P, Zaglia T, Sacconi L, Smith GL. Novel Optics-Based Approaches for Cardiac Electrophysiology: A Review. Front Physiol 2021; 12:769586. [PMID: 34867476 PMCID: PMC8637189 DOI: 10.3389/fphys.2021.769586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/18/2021] [Indexed: 12/31/2022] Open
Abstract
Optical techniques for recording and manipulating cellular electrophysiology have advanced rapidly in just a few decades. These developments allow for the analysis of cardiac cellular dynamics at multiple scales while largely overcoming the drawbacks associated with the use of electrodes. The recent advent of optogenetics opens up new possibilities for regional and tissue-level electrophysiological control and hold promise for future novel clinical applications. This article, which emerged from the international NOTICE workshop in 2018, reviews the state-of-the-art optical techniques used for cardiac electrophysiological research and the underlying biophysics. The design and performance of optical reporters and optogenetic actuators are reviewed along with limitations of current probes. The physics of light interaction with cardiac tissue is detailed and associated challenges with the use of optical sensors and actuators are presented. Case studies include the use of fluorescence recovery after photobleaching and super-resolution microscopy to explore the micro-structure of cardiac cells and a review of two photon and light sheet technologies applied to cardiac tissue. The emergence of cardiac optogenetics is reviewed and the current work exploring the potential clinical use of optogenetics is also described. Approaches which combine optogenetic manipulation and optical voltage measurement are discussed, in terms of platforms that allow real-time manipulation of whole heart electrophysiology in open and closed-loop systems to study optimal ways to terminate spiral arrhythmias. The design and operation of optics-based approaches that allow high-throughput cardiac electrophysiological assays is presented. Finally, emerging techniques of photo-acoustic imaging and stress sensors are described along with strategies for future development and establishment of these techniques in mainstream electrophysiological research.
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Affiliation(s)
| | - Allen Kelly
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Corey Acker
- Center for Cell Analysis and Modeling, UConn Health, Farmington, CT, United States
| | - Gil Bub
- Department of Physiology, McGill University, Montréal, QC, Canada
| | - Tobias Bruegmann
- Institute for Cardiovascular Physiology, University Medical Center Goettingen, Goettingen, Germany
| | - Anna Di Bona
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Emilia Entcheva
- Department of Biomedical Engineering, The George Washington University, Washington, DC, United States
| | | | - Peter Kohl
- Institute for Experimental Cardiovascular Medicine, University Heart Center and Medical Faculty, University of Freiburg, Freiburg, Germany
| | - Stephan E. Lehnart
- Heart Research Center Göttingen, University Medical Center Göttingen, Göttingen, Germany
- Department of Cardiology and Pneumology, Georg-August University Göttingen, Göttingen, Germany
- Cluster of Excellence “Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells” (MBExC), University of Göttingen, Göttingen, Germany
| | - Marco Mongillo
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- Veneto Institute of Molecular Medicine, Padova, Italy
| | | | - Claudia Richter
- German Primate Center - Leibniz Institute for Primate Research, Göttingen, Germany
| | - Philipp Sasse
- Institute of Physiology I, Medical Faculty, University of Bonn, Bonn, Germany
| | - Tania Zaglia
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- Veneto Institute of Molecular Medicine, Padova, Italy
| | - Leonardo Sacconi
- European Laboratory for Nonlinear Spectroscopy, Sesto Fiorentino, Italy
- Institute for Experimental Cardiovascular Medicine, University Heart Center and Medical Faculty, University of Freiburg, Freiburg, Germany
- National Institute of Optics, National Research Council, Florence, Italy
| | - Godfrey L. Smith
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
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25
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Majumder R, Hussaini S, Zykov VS, Luther S, Bodenschatz E. Pulsed low-energy stimulation initiates electric turbulence in cardiac tissue. PLoS Comput Biol 2021; 17:e1009476. [PMID: 34624017 PMCID: PMC8528298 DOI: 10.1371/journal.pcbi.1009476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 10/20/2021] [Accepted: 09/23/2021] [Indexed: 11/18/2022] Open
Abstract
Interruptions in nonlinear wave propagation, commonly referred to as wave breaks, are typical of many complex excitable systems. In the heart they lead to lethal rhythm disorders, the so-called arrhythmias, which are one of the main causes of sudden death in the industrialized world. Progress in the treatment and therapy of cardiac arrhythmias requires a detailed understanding of the triggers and dynamics of these wave breaks. In particular, two very important questions are: 1) What determines the potential of a wave break to initiate re-entry? and 2) How do these breaks evolve such that the system is able to maintain spatiotemporally chaotic electrical activity? Here we approach these questions numerically using optogenetics in an in silico model of human atrial tissue that has undergone chronic atrial fibrillation (cAF) remodelling. In the lesser studied sub-threshold illumination régime, we discover a new mechanism of wave break initiation in cardiac tissue that occurs for gentle slopes of the restitution characteristics. This mechanism involves the creation of conduction blocks through a combination of wavefront-waveback interaction, reshaping of the wave profile and heterogeneous recovery from the excitation of the spatially extended medium, leading to the creation of re-excitable windows for sustained re-entry. This finding is an important contribution to cardiac arrhythmia research as it identifies scenarios in which low-energy perturbations to cardiac rhythm can be potentially life-threatening.
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Affiliation(s)
| | - Sayedeh Hussaini
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute for Dynamics of Complex Systems, University of Göttingen, Göttingen, Germany
| | - Vladimir S Zykov
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
| | - Stefan Luther
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Institute for Dynamics of Complex Systems, University of Göttingen, Göttingen, Germany
| | - Eberhard Bodenschatz
- Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany
- Laboratory of Atomic and Solid-State Physics and Sibley School of Mechanical and Aerospace Engineering, Cornell University, Ithaca, New York, United States of America
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26
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Ochs AR, Karathanos TV, Trayanova NA, Boyle PM. Optogenetic Stimulation Using Anion Channelrhodopsin (GtACR1) Facilitates Termination of Reentrant Arrhythmias With Low Light Energy Requirements: A Computational Study. Front Physiol 2021; 12:718622. [PMID: 34526912 PMCID: PMC8435849 DOI: 10.3389/fphys.2021.718622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/23/2021] [Indexed: 12/24/2022] Open
Abstract
Optogenetic defibrillation of hearts expressing light-sensitive cation channels (e.g., ChR2) has been proposed as an alternative to conventional electrotherapy. Past modeling work has shown that ChR2 stimulation can depolarize enough myocardium to interrupt arrhythmia, but its efficacy is limited by light attenuation and high energy needs. These shortcomings may be mitigated by using new optogenetic proteins like Guillardia theta Anion Channelrhodopsin (GtACR1), which produces a repolarizing outward current upon illumination. Accordingly, we designed a study to assess the feasibility of GtACR1-based optogenetic arrhythmia termination in human hearts. We conducted electrophysiological simulations in MRI-based atrial or ventricular models (n = 3 each), with pathological remodeling from atrial fibrillation or ischemic cardiomyopathy, respectively. We simulated light sensitization via viral gene delivery of three different opsins (ChR2, red-shifted ChR2, GtACR1) and uniform endocardial illumination at the appropriate wavelengths (blue, red, or green light, respectively). To analyze consistency of arrhythmia termination, we varied pulse timing (three evenly spaced intervals spanning the reentrant cycle) and intensity (atrial: 0.001–1 mW/mm2; ventricular: 0.001–10 mW/mm2). In atrial models, GtACR1 stimulation with 0.005 mW/mm2 green light consistently terminated reentry; this was 10–100x weaker than the threshold levels for ChR2-mediated defibrillation. In ventricular models, defibrillation was observed in 2/3 models for GtACR1 stimulation at 0.005 mW/mm2 (100–200x weaker than ChR2 cases). In the third ventricular model, defibrillation failed in nearly all cases, suggesting that attenuation issues and patient-specific organ/scar geometry may thwart termination in some cases. Across all models, the mechanism of GtACR1-mediated defibrillation was voltage forcing of illuminated tissue toward the modeled channel reversal potential of −40 mV, which made propagation through affected regions impossible. Thus, our findings suggest GtACR1-based optogenetic defibrillation of the human heart may be feasible with ≈2–3 orders of magnitude less energy than ChR2.
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Affiliation(s)
- Alexander R Ochs
- Department of Bioengineering, University of Washington, Seattle, WA, United States
| | - Thomas V Karathanos
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Natalia A Trayanova
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States.,Alliance for Cardiovascular Diagnostic and Treatment Innovation, Johns Hopkins University, Baltimore, MD, United States
| | - Patrick M Boyle
- Department of Bioengineering, University of Washington, Seattle, WA, United States.,Institute for Stem Cell and Regenerative Medicine, University of Washington, Seattle, WA, United States.,Center for Cardiovascular Biology, University of Washington, Seattle, WA, United States
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27
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Nyns ECA, Jin T, Fontes MS, van den Heuvel T, Portero V, Ramsey C, Bart CI, Zeppenfeld K, Schalij MJ, van Brakel TJ, Ramkisoensing AA, Qi Zhang G, Poelma RH, Ördög B, de Vries AAF, Pijnappels DA. Optical ventricular cardioversion by local optogenetic targeting and LED implantation in a cardiomyopathic rat model. Cardiovasc Res 2021; 118:2293-2303. [PMID: 34528100 PMCID: PMC9328286 DOI: 10.1093/cvr/cvab294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 09/09/2021] [Indexed: 11/12/2022] Open
Abstract
AIMS Ventricular tachyarrhythmias (VTs) are common in the pathologically remodelled heart. These arrhythmias can be lethal, necessitating acute treatment like electrical cardioversion to restore normal rhythm. Recently, it has been proposed that cardioversion may also be realized via optically controlled generation of bioelectricity by the arrhythmic heart itself through optogenetics and therefore without the need of traumatizing high-voltage shocks. However, crucial mechanistic and translational aspects of this strategy have remained largely unaddressed. Therefore, we investigated optogenetic termination of VTs 1) in the pathologically remodelled heart using a 2) implantable multi-LED device for 3) in vivo closed-chest, local illumination. METHODS AND RESULTS In order to mimic a clinically relevant sequence of events, transverse aortic constriction (TAC) was applied to adult male Wistar rats before optogenetic modification. This modification took place three weeks later by intravenous delivery of adeno-associated virus vectors encoding red-activatable channelrhodopsin (ReaChR) or Citrine for control experiments. At 8 to 10 weeks after TAC, VTs were induced ex vivo and in vivo, followed by programmed local illumination of the ventricular apex by a custom-made implanted multi-LED device. This resulted in effective and repetitive VT termination in the remodelled adult rat heart after optogenetic modification, leading to sustained restoration of sinus rhythm in the intact animal. Mechanistically, studies on the single cell and tissue level revealed collectively that, despite the cardiac remodelling, there were no significant differences in bioelectricity generation and subsequent transmembrane voltage responses between diseased and control animals, thereby providing insight into the observed robustness of optogenetic VT termination. CONCLUSION Our results show that implant-based optical cardioversion of VTs is feasible in the pathologically remodelled heart in vivo after local optogenetic targeting because of preserved optical control over bioelectricity generation. These findings add novel mechanistic and translational insight into optical ventricular cardioversion.
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Affiliation(s)
- Emile C A Nyns
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Tianyi Jin
- Department of Microelectronics, Delft University of Technology, Delft, the Netherlands
| | - Magda S Fontes
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Titus van den Heuvel
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Vincent Portero
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Catilin Ramsey
- Department of Microelectronics, Delft University of Technology, Delft, the Netherlands
| | - Cindy I Bart
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Katja Zeppenfeld
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Martin J Schalij
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | | | - Arti A Ramkisoensing
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Guo Qi Zhang
- Department of Microelectronics, Delft University of Technology, Delft, the Netherlands
| | - René H Poelma
- Department of Microelectronics, Delft University of Technology, Delft, the Netherlands
| | - Balazs Ördög
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Antoine A F de Vries
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
| | - Daniël A Pijnappels
- Laboratory of Experimental Cardiology, Department of Cardiology, Leiden University Medical Center (LUMC), Leiden, the Netherlands
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28
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Abstract
Computer simulations show how low-intensity illumination can be used to terminate cardiac arrhythmias.
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Affiliation(s)
- Eike M Wülfers
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg – Bad KrozingenBad KrozingenGermany
- Faculty of Medicine, University of FreiburgFreiburgGermany
| | - Franziska Schneider-Warme
- Institute for Experimental Cardiovascular Medicine, University Heart Center Freiburg – Bad KrozingenBad KrozingenGermany
- Faculty of Medicine, University of FreiburgFreiburgGermany
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29
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Abstract
The electromechanical function of the heart involves complex, coordinated activity over time and space. Life-threatening cardiac arrhythmias arise from asynchrony in these space-time events; therefore, therapies for prevention and treatment require fundamental understanding and the ability to visualize, perturb and control cardiac activity. Optogenetics combines optical and molecular biology (genetic) approaches for light-enabled sensing and actuation of electrical activity with unprecedented spatiotemporal resolution and parallelism. The year 2020 marks a decade of developments in cardiac optogenetics since this technology was adopted from neuroscience and applied to the heart. In this Review, we appraise a decade of advances that define near-term (immediate) translation based on all-optical electrophysiology, including high-throughput screening, cardiotoxicity testing and personalized medicine assays, and long-term (aspirational) prospects for clinical translation of cardiac optogenetics, including new optical therapies for rhythm control. The main translational opportunities and challenges for optogenetics to be fully embraced in cardiology are also discussed.
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