Optimising low-energy defibrillation in 2D cardiac tissue with a genetic algorithm

Marcel Aron; Thomas Lilienkamp; Stefan Luther; Ulrich Parlitz

doi:10.3389/fnetp.2023.1172454

Optimising low-energy defibrillation in 2D cardiac tissue with a genetic algorithm

Front Netw Physiol. 2023 Jul 24:3:1172454. doi: 10.3389/fnetp.2023.1172454. eCollection 2023.

Authors

Marcel Aron^{1

2

3

4}, Thomas Lilienkamp^{2

5}, Stefan Luther^{1

2

3

4}, Ulrich Parlitz^{2

3

4}

Affiliations

¹ Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen, Germany.
² Max Planck Institute for Dynamics and Self-Organization, Göttingen, Germany.
³ Institute for the Dynamics of Complex Systems, Georg-August-Universität Göttingen, Göttingen, Germany.
⁴ German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany.
⁵ Computational Physics for Life Science, Nuremberg Institute of Technology Georg Simon Ohm, Nuremberg, Germany.

Abstract

Sequences of low-energy electrical pulses can effectively terminate ventricular fibrillation (VF) and avoid the side effects of conventional high-energy electrical defibrillation shocks, including tissue damage, traumatic pain, and worsening of prognosis. However, the systematic optimisation of sequences of low-energy pulses remains a major challenge. Using 2D simulations of homogeneous cardiac tissue and a genetic algorithm, we demonstrate the optimisation of sequences with non-uniform pulse energies and time intervals between consecutive pulses for efficient VF termination. We further identify model-dependent reductions of total pacing energy ranging from ∼4% to ∼80% compared to reference adaptive-deceleration pacing (ADP) protocols of equal success rate (100%).

Keywords: cardiac arrhythmias; chaos control; excitable media; low-energy defibrillation; ventricular fibrillation.

Grants and funding

The authors acknowledge funding by the Excellence Cluster MBExC (project “Motion analysis of excitable biological media using machine learning”), by the Max Planck Society (MPG) and the German Centre for Cardiovascular Research (DZHK) e.V.