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

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%).

Chaos control in cardiac dynamics: terminating chaotic states with local minima pacing

“… Otani et al, 2019 performed 3D simulations on a simplified ventricular geometry, to show the impact of the direction of an external electrical field on the success rate for defibrillation. Other protocols aim to apply either single stimuli at specific points in time ( Trayanova, 2006 ; Steyer et al, 2023 ) or pulse sequences at predefined periods/frequencies ( Fenton et al, 2009 ; Janardhan et al, 2014 ; Buran et al, 2017 ; Hornung et al, 2017 ; Lilienkamp et al, 2022a ; Lilienkamp et al, 2022b ; Aron et al, 2023 ). The timing of pulses can also be determined by feedback-controlled protocols, which incorporate the underlying dynamics and the reaction of the system to stimuli.…”