Session S73.6

Feedback Control of Resonant Drift as a Tool for Low Voltage Defibrillation

IV Biktasheva*, SW Morgan, G Plank, VN Biktashev

University of Liverpool
Liverpool, UK

Objectives: Strong shocks used in conventional ICDs have severe detrimental effects which motivates search for low-voltage alternatives. Resonant drift of re-entry occurs in response to repetitive stimulation with period equal to that of the re-entrant pattern. Feedback can maintain the resonance, drive the re-entry from the excitable tissue and thus terminate it. We test the feasibility of this approach using computer simulations.
Methods: We used monodomain and bidomain description, rectangular two-and three-dimensional geometry as well as anatomically realistic rabbit ventricles geometry, and excitable models of Barkley, Drouhard-Roberge-Beeler-Reuter and Courtemanche-Ramirez-Nattel.
Results: Termination of re-entries can be achieved with high probability at a fraction of the conventional shock strength, by moving the re-entry cores towards an anatomical boundary or towards each other. The movement depends on the electrodes’ location and details of the feedback protocol. Simulations reveal reasons when the protocol has not been successful and can suggest modifications to it to overcome the difficulties.
Conclusions: The evidence from simulations motivates experimental testing of the proposed low-voltage defibrillation method. Such testing will be most productive if done in conjunction with simulations.

(Abstract Control Number: 149)