Washington University

Max-planck-gesellschaft Zur F&#xf6;rderung Der Wissenschaften E. V.

Cornell University

Valentin I Krinski

Igor R Efimov

Vladmir P Nikolski

Eberhard Bodenschatz

Stefan Luther

Robert Gilmour

Flavio H Fenton

Vladimir P Nikolski

A method for extinguishing a cardiac arrhythmia utilizes destructive interference of the passing of the reentry wave tip of an anatomical reentry through a depolarized region created by a relatively low voltage electric field in such a way as to effectively unpin the anatomical reentry. Preferably, the relatively low voltage electric field is defined by at least one unpinning shock(s) that are lower than an expected lower limit of vulnerability as established, for example, by a defibrillation threshold test. By understanding the physics of the electric field distribution between cardiac cells, the method permits the delivery of an electric field sufficient to unpin the core of the anatomical reentry, whether the precise or estimated location of the reentry is known or unknown and without the risk of inducting ventricular fibrillation. A number of embodiments for performing the method are disclosed.

Method for low-voltage termination of cardiac arrhythmias by effectively unpinning anatomical reentries

High frequency cardiac arrhythmias and fibrillations are terminated by electric field pacing pulses having an order of magnitude less energy than a conventional cardioversion or defibrillation energy. The frequency and number of the pulses are selected based on a frequency analysis of a present high frequency cardiac arrhythmia or fibrillation. The energy of the pulses is selected from 1/400 to &#xbd; of the conventional defibrillation energy, and the amplitude of the electric field pacing pulses are selected such as to activate a multitude of effective pacing sites in the heart tissue per each pacing electrode. The number and locations of the effective pacing sites in the heart tissue are regulated by the amplitude of the electric field pacing pulses, and by an orientation of the electric field of the pulses.

Multisite heart pacing with adjustable number of pacing sites for terminating high frequency cardiac arrhythmias

For terminating a high frequency arrhythmic electric state of a heart an electric signal representative of the present electric state of the heart is obtained. From the electric signal a dominant frequency of the present electric state is determined, and from the dominant frequency it is determined whether the present electric state of the heart is a high frequency arrhythmic electric state displaying at least one rotating wave. Further, a dominance level indicative of how dominant the dominant frequency is in the high frequency arrhythmic electric state is determined from the electric signal. Depending on the at least one dominant frequency, at least one series of electric pulses at intervals is generated. The electric pulses are applied to the heart starting at a point in time at which the dominance level exceeds a predefined threshold value for the heart being in a determined high frequency arrhythmic electric state.

Apparatus for terminating a high frequency arrhythmic electric state of a heart

For terminating a high frequency arrhythmic electric state of a biological tissue an electric signal representative of the present electric state of the biological tissue is obtained. From the electric signal a dominant frequency of the present electric state is determined, and from the dominant frequency it is determined whether the present electric state of the biological tissue is a high frequency arrhythmic electric state. Further, a dominance level indicative of how dominant the dominant frequency is in the high frequency arrhythmic electric state is determined from the electric signal. Depending on the at least one dominant frequency, at least one series of electric pulses at intervals is generated. The electric pulses are applied to the biological tissue starting at a point in time at which the dominance level exceeds a predefined threshold value for the biological tissue being in a determined high frequency arrhythmic electric state.

Growing community of inventors

Villeneuve Loubet, France

Valentin I Krinski