Monitoring and Modulating Cardiac Bioelectricity: from Einthoven to End-user

Overview

Journal Europace

Publisher Oxford University Press

Specialties Cardiology & Vascular Diseases
Physiology

Date 2024 Dec 24

PMID 39716965

Authors

Tim De Coster

Arman Nobacht

Thom Oostendorp

Antoine A F de Vries

Ruben Coronel

Daniel A Pijnappels

Affiliations

Soon will be listed here.

Abstract

In 2024, we celebrate the 100th anniversary of Willem Einthoven receiving the Nobel Prize for his discovery of the mechanism of the electrocardiogram (ECG). Building on Einthoven's legacy, electrocardiography allows the monitoring of cardiac bioelectricity through solutions to the so-called forward and inverse problems. These solutions link local cardiac electrical signals with the morphology of the ECG, offering a reversible connection between the heart's electrical activity and its representation on the body surface. Inspired by Einthoven's work, researchers have explored the transition from monitoring to modulation of bioelectrical activity in the heart for the development of new anti-arrhythmic strategies, e.g. via optogenetics. In this review, we demonstrate the lasting influence that Einthoven has on our understanding of cardiac electrophysiology in general, and the diagnosis and treatment of cardiac arrhythmias in particular.

Citing Articles

Commemorating the 1924 Nobel Prize awarded to Willem Einthoven: a century of progress in electrocardiography and arrhythmia research.

Remme C, Odening K Europace. 2024; 27(1.

PMID: 39729542 PMC: 11707386. DOI: 10.1093/europace/euae309.

References

Defauw A, Vandersickel N, Dawyndt P, Panfilov A . Small size ionic heterogeneities in the human heart can attract rotors. Am J Physiol Heart Circ Physiol. 2014; 307(10):H1456-68. DOI: 10.1152/ajpheart.00410.2014. View

Jung E, Choi H, Song H, Hwang Y, Kim A, Ryu H . p53-dependent SIRT6 expression protects Aβ42-induced DNA damage. Sci Rep. 2016; 6:25628. PMC: 4860716. DOI: 10.1038/srep25628. View

Majumder R, Feola I, Teplenin A, de Vries A, Panfilov A, Pijnappels D . Optogenetics enables real-time spatiotemporal control over spiral wave dynamics in an excitable cardiac system. Elife. 2018; 7. PMC: 6195347. DOI: 10.7554/eLife.41076. View

Kleinlogel S, Feldbauer K, Dempski R, Fotis H, Wood P, Bamann C . Ultra light-sensitive and fast neuronal activation with the Ca²+-permeable channelrhodopsin CatCh. Nat Neurosci. 2011; 14(4):513-8. DOI: 10.1038/nn.2776. View

Hindricks G, Potpara T, Dagres N, Arbelo E, Bax J, Blomstrom-Lundqvist C . 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the.... Eur Heart J. 2020; 42(5):373-498. DOI: 10.1093/eurheartj/ehaa612. View

van der Waal J, Meijborg V, Coronel R, Dubois R, Oostendorp T . Basis and applicability of noninvasive inverse electrocardiography: a comparison between cardiac source models. Front Physiol. 2023; 14:1295103. PMC: 10752226. DOI: 10.3389/fphys.2023.1295103. View

Tzou W, Marchlinski F, Zado E, Lin D, Dixit S, Callans D . Long-term outcome after successful catheter ablation of atrial fibrillation. Circ Arrhythm Electrophysiol. 2010; 3(3):237-42. DOI: 10.1161/CIRCEP.109.923771. View

Bruegmann T, Malan D, Hesse M, Beiert T, Fuegemann C, Fleischmann B . Optogenetic control of heart muscle in vitro and in vivo. Nat Methods. 2010; 7(11):897-900. DOI: 10.1038/nmeth.1512. View

Nyns E, Poelma R, Volkers L, Plomp J, Bart C, Kip A . An automated hybrid bioelectronic system for autogenous restoration of sinus rhythm in atrial fibrillation. Sci Transl Med. 2019; 11(481). DOI: 10.1126/scitranslmed.aau6447. View

Wellens H, Lau C, Luderitz B, Akhtar M, Waldo A, Camm A . Atrioverter: an implantable device for the treatment of atrial fibrillation. Circulation. 1998; 98(16):1651-6. DOI: 10.1161/01.cir.98.16.1651. View

10.

HOLLAND R, Arnsdorf M . Solid angle theory and the electrocardiogram: physiologic and quantitative interpretations. Prog Cardiovasc Dis. 1977; 19(6):431-57. DOI: 10.1016/0033-0620(77)90009-3. View

11.

Nyns E, Kip A, Bart C, Plomp J, Zeppenfeld K, Schalij M . Optogenetic termination of ventricular arrhythmias in the whole heart: towards biological cardiac rhythm management. Eur Heart J. 2016; 38(27):2132-2136. PMC: 5837774. DOI: 10.1093/eurheartj/ehw574. View

12.

Lin J, Knutsen P, Muller A, Kleinfeld D, Tsien R . ReaChR: a red-shifted variant of channelrhodopsin enables deep transcranial optogenetic excitation. Nat Neurosci. 2013; 16(10):1499-508. PMC: 3793847. DOI: 10.1038/nn.3502. View

13.

Bray M, Wikswo J . Considerations in phase plane analysis for nonstationary reentrant cardiac behavior. Phys Rev E Stat Nonlin Soft Matter Phys. 2002; 65(5 Pt 1):051902. DOI: 10.1103/PhysRevE.65.051902. View

14.

Deisseroth K, Feng G, Majewska A, Miesenbock G, Ting A, Schnitzer M . Next-generation optical technologies for illuminating genetically targeted brain circuits. J Neurosci. 2006; 26(41):10380-6. PMC: 2820367. DOI: 10.1523/JNEUROSCI.3863-06.2006. View

15.

Pravdin S, Dierckx H, Markhasin V, Panfilov A . Drift of Scroll Wave Filaments in an Anisotropic Model of the Left Ventricle of the Human Heart. Biomed Res Int. 2015; 2015:389830. PMC: 4619794. DOI: 10.1155/2015/389830. View

16.

Meijborg V, Conrath C, Opthof T, Belterman C, de Bakker J, Coronel R . Electrocardiographic T wave and its relation with ventricular repolarization along major anatomical axes. Circ Arrhythm Electrophysiol. 2014; 7(3):524-31. DOI: 10.1161/CIRCEP.113.001622. View

17.

Funken M, Malan D, Sasse P, Bruegmann T . Optogenetic Hyperpolarization of Cardiomyocytes Terminates Ventricular Arrhythmia. Front Physiol. 2019; 10:498. PMC: 6491897. DOI: 10.3389/fphys.2019.00498. View

18.

Abu Shama R, Nery P, Sadek M, Yung D, Redpath C, Perrin M . Myocardial injury secondary to ICD shocks: insights from patients with lead fracture. Pacing Clin Electrophysiol. 2013; 37(2):237-41. DOI: 10.1111/pace.12263. View

19.

Potse M, Vinet A, Opthof T, Coronel R . Validation of a simple model for the morphology of the T wave in unipolar electrograms. Am J Physiol Heart Circ Physiol. 2009; 297(2):H792-801. DOI: 10.1152/ajpheart.00064.2009. View