title: The potential of ultrasound in cardiac pacing and rhythm modulation.
abstract: BACKGROUND
  This review examines the potential for ultrasound to induce or otherwise influence cardiac pacing and rhythm modulation.
  
  
  METHODS
  Of particular interest is the possibility of developing new, truly non-invasive, nonpharmacological, acute and chronic, ultrasound-based arrhythmia treatments. Such approaches would not depend upon implanted or indwelling devices of any kind and would use ultrasound at diagnostic exposure levels (so as not to harm the heart or surrounding tissues). It is known that ultrasound can cause cardiomyocyte depolarization and a variety of underlying mechanisms have been proposed. Expert commentary: Questions still remain regarding the effect of exposure parameters and work will also be necessary to identify the optimal target regions within the heart if ultrasound energy is to be used to induce safe and reliable pacing in a clinical setting.
authors.affiliation: a School of Medicine , Drexel University , Philadelphia , PA , USA.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Kohut
authors.affiliation: b School of Biomedical Engineering, Science and Health System , Drexel University , Philadelphia , PA , USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Vecchio
authors.affiliation: c Department of Biomedical Engineering , Technion - Israel Institute of Technology , Haifa , Israel.
authors.forename: Dan
authors.initials: D
authors.lastname: Adam
authors.affiliation: b School of Biomedical Engineering, Science and Health System , Drexel University , Philadelphia , PA , USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lewin
mesh_terms: D002304:Cardiac Pacing, Artificial; D005347:Fibroblasts / Q000166:cytology; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D032383:Myocytes, Cardiac / Q000166:cytology; D014465:Ultrasonics / Q000379:methods*; D014630:Vagus Nerve / Q000502:physiology
keywords: Focused ultrasound; cardiac pacing; mechano-electric coupling; mechano-electric feedback; mechanosensitivity; percussive pacing; premature ventricular contractions