4.6 Review

Optogenetic Termination of Cardiac Arrhythmia: Mechanistic Enlightenment and Therapeutic Application?

Journal

FRONTIERS IN PHYSIOLOGY
Volume 10, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fphys.2019.00675

Keywords

optogenetics; defibrillation; cardioversion; ventricular arrhythmia; ventricular tachycardia; ventricular fibrillation; atrial fibrillation; implantable cardioverter defibrillator

Categories

Funding

  1. German Research Foundation [313904155/SA1785/7-1, 380524518/SA1785/9-1, 214362475/GRK1873/2, SPP 1926, GO1011/11-1]
  2. BONFOR Program, Medical Faculty, University of Bonn
  3. German Federal Ministry of Education and Research, program Photonics Research Germany, project BioPACE [13N14087]
  4. DZHK (German Centre for Cardiovascular Research)
  5. Gottingen University

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Optogenetic methods enable selective de- and hyperpolarization of cardiomyocytes expressing light-sensitive proteins within the myocardium. By using light, this technology provides very high spatial and temporal precision, which is in clear contrast to electrical stimulation. In addition, cardiomyocyte-specific expression would allow pain-free stimulation. In light of these intrinsic technical advantages, optogenetic methods provide an intriguing opportunity to understand and improve current strategies to terminate cardiac arrhythmia as well as for possible pain-free arrhythmia termination in patients in the future. In this review, we give a concise introduction to optogenetic stimulation of cardiomyocytes and the whole heart and summarize the recent progress on optogenetic defibrillation and cardioversion to terminate cardiac arrhythmia. Toward this aim, we specifically focus on the different mechanisms of optogenetic arrhythmia termination and how these might influence the prerequisites for success. Furthermore, we critically discuss the clinical perspectives and potential patient populations, which might benefit from optogenetic defibrillation devices.

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