A hybrid stimulation strategy for suppression of spiral waves in cardiac tissue

Atrial fibrillation (AF) is the most common cardiac arrhythmia whose mechanisms are thought to be mainly due to the self perpetuation of spiral waves (SW). To date, available treatment strategies (antiarrhythmic drugs, radiofrequency ablation of the substrate, electrical cardioversion) to restore and to maintain a normal sinus rhythm have limitations and are associated with AF recurrences. The aim of this study was to assess a way of suppressing SW by applying multifocal electrical stimulations in a simulated cardiac tissue using a 2D FitzHugh–Nagumo model specially convenient for AF investigations. We identified stimulation parameters for successful termination of SW. However, SW reinduction, following the electrical stimuli, leads us to develop a hybrid strategy based on sodium channel modification for the simulated tissue.

► Simulation of a cardiac tissue by a modified 2D FitzHugh–Nagumo model.
► Stimulation of monophasic impulsions from a grid of electrodes to the cardiac tissue.
► Propose a method by modifying the tissue’s sodium channels and electrical stimulation.
► The method leading to suppress spiral waves without generating new ones.
► Optimal parameters of a successful suppression of spiral waves are investigated.