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Optogenetic Termination of Cardiac Arrhythmia: Mechanistic Enlightenment and Therapeutic Application?

Authors
  • Sasse, Philipp1
  • Funken, Maximilian1, 2
  • Beiert, Thomas2
  • Bruegmann, Tobias1, 3, 4, 5
  • 1 Institute of Physiology I, Medical Faculty, University of Bonn, Bonn, Germany. , (Germany)
  • 2 Department of Internal Medicine II, University Hospital Bonn, University of Bonn, Bonn, Germany. , (Germany)
  • 3 Research Training Group 1873, University of Bonn, Bonn, Germany. , (Germany)
  • 4 Institute of Cardiovascular Physiology, University Medical Center, Georg August University Göttingen, Göttingen, Germany. , (Germany)
  • 5 German Center for Cardiovascular Research (DZHK), Partner site Göttingen, Göttingen, Germany. , (Germany)
Type
Published Article
Journal
Frontiers in Physiology
Publisher
Frontiers Media SA
Publication Date
Jan 01, 2019
Volume
10
Pages
675–675
Identifiers
DOI: 10.3389/fphys.2019.00675
PMID: 31244670
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Optogenetic methods enable selective de- and hyperpolarization of cardiomyocytes expressing light-sensitive proteins within the myocardium. By using light, this technology provides very high spatial and temporal precision, which is in clear contrast to electrical stimulation. In addition, cardiomyocyte-specific expression would allow pain-free stimulation. In light of these intrinsic technical advantages, optogenetic methods provide an intriguing opportunity to understand and improve current strategies to terminate cardiac arrhythmia as well as for possible pain-free arrhythmia termination in patients in the future. In this review, we give a concise introduction to optogenetic stimulation of cardiomyocytes and the whole heart and summarize the recent progress on optogenetic defibrillation and cardioversion to terminate cardiac arrhythmia. Toward this aim, we specifically focus on the different mechanisms of optogenetic arrhythmia termination and how these might influence the prerequisites for success. Furthermore, we critically discuss the clinical perspectives and potential patient populations, which might benefit from optogenetic defibrillation devices.

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