Nonlinear-dynamical arrhythmia control in humans
Nonlinear-dynamical arrhythmia control in humans
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DOI：
10.1073/pnas.091553398
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发表时间：
2001-05-08
影响因子：
11.1
通讯作者：
Lerman, BB
中科院分区：
文献类型：
--
作者：
Christini, DJ;Stein, KM;Lerman, BB
非线性动力学控制技术，也被称为混沌控制，已经成功地应用于控制广泛的物理系统。这些技术已经被用来控制体外可兴奋生物组织的行为，这表明它们具有临床应用的潜力。然而，使用这种技术来控制生理过程的可行性还没有在人类身上得到证明。在这里，我们表明，非线性动力学控制可以通过快速稳定不稳定的目标节律来调制人类心脏电生理动力学。具体地说，在5名患者的52/54次对照试验中，我们通过稳定基础的不稳定稳态传导，成功地终止了起搏诱导的2期房室结传导交替。这一概念验证表明，非线性动态控制技术在临床上是可行的，并为开发针对更复杂形式的临床心律失常的此类技术提供了基础。
Nonlinear-dynamical control techniques, also known as chaos control, have been used with great success to control a wide range of physical systems. Such techniques have been used to control the behavior of in vitro excitable biological tissue, suggesting their potential for clinical utility. However, the feasibility of using such techniques to control physiological processes has not been demonstrated in humans. Here we show that nonlinear-dynamical control can modulate human cardiac electrophysiological dynamics by rapidly stabilizing an unstable target rhythm. Specifically, in 52/54 control attempts in five patients, we successfully terminated pacing-induced period-2 atrioventricular-nodal conduction alternans by stabilizing the underlying unstable steady-state conduction. This proof-of-concept demonstration shows that nonlinear-dynamical control techniques are clinically feasible and provides a foundation for developing such techniques for more complex forms of clinical arrhythmia.