ArticleCirculation. Arrhythmia and electrophysiology2020
Real-Time Closed-Loop Suppression of Repolarization Alternans Reduces Arrhythmia Susceptibility In Vivo.
Article in Circulation. Arrhythmia and electrophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Clinical Potential of Beat-to-Beat Diastolic Interval Control in Preventing Cardiac Arrhythmias.Journal of the American Heart Association · 2021Pooled it
- Low-Level Tragus Stimulation Modulates Atrial Alternans and Fibrillation Burden in Patients With Paroxysmal Atrial Fibrillation.Journal of the American Heart Association · 2021Trial
- Prioritizing Discovery and Advancements in Arrhythmia Therapies: NIH/NHLBI Workshop.JACC. Clinical electrophysiology · 2026Review
- Prognostic Role of Electrocardiographic Alternans in Ischemic Heart Disease.Journal of clinical medicine · 2025Article
- Multifunctional hydrogel electronics for closed-loop antiepileptic treatment.Science advances · 2024Article
- Cardiac contractility modulation in patients with heart failure - A review of the literature.Heart failure reviews · 2024Review
- The physics of heart rhythm disorders.Physics reports · 2022Article
- Ambulatory monitoring promises equitable personalized healthcare delivery in underrepresented patients.European heart journal. Digital health · 2021Review
- Microvolt T-Wave Alternans Is Modulated by Acute Low-Level Tragus Stimulation in Patients With Ischemic Cardiomyopathy and Heart Failure.Frontiers in physiology · 2021Article
- Advances in Cardiac Pacing: Arrhythmia Prediction, Prevention and Control Strategies.Frontiers in physiology · 2021Review
- 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
11 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundRepolarization alternans (RA) has been implicated in the pathogenesis of ventricular arrhythmias and sudden cardiac death.
methodsWe have developed a real-time, closed-loop system to record and analyze RA from multiple intracardiac leads, and deliver dynamically R-wave triggered pacing stimuli during the absolute refractory period. We have evaluated the ability of this system to control RA and reduce arrhythmia susceptibility, in vivo.
resultsR-wave triggered pacing can induce RA, the magnitude of which can be modulated by varying the amplitude, pulse width, and size of the pacing vector. Using a swine model (n=9), we demonstrate that to induce a 1 µV change in the alternans voltage on the body surface, coronary sinus and left ventricle leads, requires a delivered charge of 0.04±0.02, 0.05±0.025, and 0.06±0.033 µC, respectively, while to induce a one unit change of the K
conclusionsWe have developed and evaluated a novel closed-loop method to dynamically modulate RA in a swine model. Our data suggest that suppression of RA directly reduces arrhythmia susceptibility and reinforces the concept that RA plays a critical role in the pathophysiology of arrhythmogenesis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.