ArticleAnnals of biomedical engineering2018
Real-Time Closed Loop Diastolic Interval Control Prevents Cardiac Alternans in Isolated Whole Rabbit Hearts.
Article in Annals of biomedical engineering, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical Potential of Beat-to-Beat Diastolic Interval Control in Preventing Cardiac Arrhythmias.Journal of the American Heart Association · 2021Pooled it
- Targeted Atrial Fibrillation Therapy and Risk Stratification Using Atrial Alternans.Journal of cardiovascular development and disease · 2023Review
- A machine-learning approach for long-term prediction of experimental cardiac action potential time series using an autoencoder and echo state networks.Chaos (Woodbury, N.Y.) · 2022Article
- Long-Time Prediction of Arrhythmic Cardiac Action Potentials Using Recurrent Neural Networks and Reservoir Computing.Frontiers in physiology · 2021Article
- A Phase Defect Framework for the Analysis of Cardiac Arrhythmia Patterns.Frontiers in physiology · 2021Article
- Advances in Cardiac Pacing: Arrhythmia Prediction, Prevention and Control Strategies.Frontiers in physiology · 2021Review
- Feedback control of calcium driven alternans in cardiac myocytes.Chaos (Woodbury, N.Y.) · 2020Article
- Cardiac Alternans: Mechanisms and Clinical Utility in Arrhythmia Prevention.Journal of the American Heart Association · 2019Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Cardiac alternans, a beat-to-beat alternation in action potential duration (APD), can lead to fatal arrhythmias. During periodic pacing, changes in diastolic interval (DI) depend on subsequent changes in APD, thus enhancing cardiac instabilities through a 'feedback' mechanism. Recently, an anti-arrhythmic Constant DI pacing protocol was proposed and shown to be effective in suppressing alternans in 0D and 1D in silico studies. However, previous experimental validation of Constant DI pacing in the heart has been unsuccessful due to the spatio-temporal complexity of 2D cardiac tissue and the technical challenges in its real-time implementation. Here, we developed a novel closed loop system to detect T-waves from real-time ECG data, enabling successful implementation of Constant DI pacing protocol, and performed high-resolution optical mapping experiments on isolated whole rabbit hearts to validate its anti-arrhythmic effects. The results were compared with: (1) Periodic pacing (feedback inherent) and (2) pacing with heart rate variability (HRV) (feedback modulation) introduced by using either Gaussian or Physiological patterns. We observed that Constant DI pacing significantly suppressed alternans in the heart, while maintaining APD spatial dispersion and flattening the slope of the APD restitution curve, compared to traditional Periodic pacing. In addition, introduction of HRV in Periodic pacing failed to prevent cardiac alternans, and was arrhythmogenic.
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Registered trials
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