title: Mechanisms of vortices termination in the cardiac muscle.
abstract: We propose a solution to a long-standing problem: how to terminate multiple vortices in the heart, when the locations of their cores and their critical time windows are unknown. We scan the phases of all pinned vortices in parallel with electric field pulses (E-pulses). We specify a condition on pacing parameters that guarantees termination of one vortex. For more than one vortex with significantly different frequencies, the success of scanning depends on chance, and all vortices are terminated with a success rate of less than one. We found that a similar mechanism terminates also a free (not pinned) vortex. A series of about 500 experiments with termination of ventricular fibrillation by E-pulses in pig isolated hearts is evidence that pinned vortices, hidden from direct observation, are significant in fibrillation. These results form a physical basis needed for the creation of new effective low energy defibrillation methods based on the termination of vortices underlying fibrillation.
authors.affiliation: Max Planck Institute DS , BMPG, Gottingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Hornung
authors.affiliation: University of Exeter , Exeter, UK.
authors.forename: V N
authors.identifier: 0000-0001-6617-4677
authors.initials: VN
authors.lastname: Biktashev
authors.affiliation: Rochester Institute of Technology , Rochester, NY, USA.
authors.forename: N F
authors.initials: NF
authors.lastname: Otani
authors.affiliation: National Institute of Technology Karnataka , Bangalore, India.
authors.forename: T K
authors.initials: TK
authors.lastname: Shajahan
authors.affiliation: Max Planck Institute DS, BMPG, Gottingen, Germany; Institute for Nonlinear Dynamics, Georg-August-Universität Göttingen, Am Faßberg 17, 37077 Göttingen.
authors.forename: T
authors.initials: T
authors.lastname: Baig
authors.affiliation: Max Planck Institute DS, BMPG, Gottingen, Germany; Institute for Nonlinear Dynamics, Georg-August-Universität Göttingen, Am Faßberg 17, 37077 Göttingen.
authors.forename: S
authors.initials: S
authors.lastname: Berg
authors.affiliation: Rochester Institute of Technology , Rochester, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Han
authors.affiliation: Max Planck Institute DS, BMPG, Gottingen, Germany; INLN, CNRS, Valbonne, France.
authors.forename: V I
authors.initials: VI
authors.lastname: Krinsky
authors.affiliation: Max Planck Institute DS, BMPG, Gottingen, Germany; Institute for Nonlinear Dynamics, Georg-August-Universität Göttingen, Am Faßberg 17, 37077 Göttingen; Department of Pharmacology, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075 Göttingen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Luther
keywords: cardiac fibrillation; implantable defibrillator; nonlinear waves; weakly pinned vortices