Research ArticleAtrial Fibrillation

An automated hybrid bioelectronic system for autogenous restoration of sinus rhythm in atrial fibrillation

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Science Translational Medicine  27 Feb 2019:
Vol. 11, Issue 481, eaau6447
DOI: 10.1126/scitranslmed.aau6447

Atrial fibrillation treatment lightens up

Atrial fibrillation is an irregular, rapid heartbeat that interrupts normal blood flow and increases risk of stroke and clots. Normal heart rhythm can be restored by electroshock (electrical cardioversion), but implantable cardioverter defibrillators can cause pain and damage myocardial tissue. Rather than supply exogenous current, Nyns et al. combined atrial gene painting to deliver viral vectors encoding light-activatable ion channels with an implantable light source and rhythm detector, developing an autogenous arrhythmia termination system. This optogenetic approach restored normal heart rhythm in rat hearts ex vivo and in vivo under closed-chest conditions. Further testing in larger animal models is necessary, but results suggest that this could be a pain-free alternative to electroshock.

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