Optimal Termination of Spiral Waves Associated with Cardiac Arrhythmias

与心律失常相关的螺旋波的最佳终止

• 批准号: 1363243
• 负责人: Jeffrey Moehlis
• 金额: $ 37.5万
• 依托单位: University of California-Santa Barbara
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2018-03-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1363243&HistoricalAwards=false
• 关键词: Optimal; Termination; Spiral; Waves; Associated

The objective of this award is the development of novel methodologies for treating cardiac arrhythmias associated with abnormal electrical activity in the heart. This will include the computation of energy-optimal stimuli which drive the states of myocardial cells to a region of phase space for which they become nearly synchronized, thereby terminating spiral wave activity and preventing spiral wave reentry. The algorithm used to accomplish this will involve new computational approaches for finding appropriate target regions of phase space and solving the Hamilton-Jacobi-Bellman equation in higher dimensions. Another methodology will use the action potential duration restitution curve, which is an experimentally measurable function that describes the duration of an action potential as a function of the time since the end of the preceding action potential. Given this curve, the methods of dynamic programming will be applied to determine an optimal pulse train within a family of possibilities for synchronization of myocardial activity.Cardiac arrhythmias can disrupt the coordination that is essential for the effective pumping of blood, and can lead to cardiac arrest. Survivors of cardiac arrest often receive an implantable cardioverter defibrillator (ICD), but defibrillating shocks from ICDs can lead to fibrosis in the myocardium, making it necessary to use stronger defibrillating shocks. The shocks can also cause adverse short-term side effects such as intense chest pain and post-shock dysfunction. If successful, this research will represent an early step toward the use of energy-optimal stimuli for ICDs, which would reduce the need for surgical replacement of their batteries,and might mitigate some of the deleterious side effects of defibrillation. This work will also contribute to the development of computational tools which can be used to find optimal control strategies in a wide range of applications.

该奖项的目的是开发治疗与心脏异常电活动相关的心律失常的新方法。 这将包括能量最佳刺激的计算，该能量最佳刺激将心肌细胞的状态驱动到它们变得几乎同步的相空间区域，从而终止螺旋波活动并防止螺旋波折返。 用于实现这一点的算法将涉及新的计算方法，用于找到相空间的适当目标区域并在更高维中求解Hamilton-Jacobi-Bellman方程。 另一种方法将使用动作电位持续时间恢复曲线，其是实验上可测量的函数，其将动作电位的持续时间描述为自前一动作电位结束以来的时间的函数。 给定该曲线，动态规划的方法将被应用于确定一个最佳的脉冲序列中的一个家庭的可能性同步的心肌activity.Cardiac心律失常可能会破坏协调，这是必不可少的有效泵血，并可能导致心脏骤停。心脏骤停的幸存者通常会接受植入式心律转复除颤器（ICD），但ICD的复律电击会导致心肌纤维化，因此有必要使用更强的复律电击。 电击还可能导致短期不良副作用，如剧烈胸痛和电击后功能障碍。如果成功，这项研究将代表使用能量最佳刺激ICD的早期步骤，这将减少手术更换电池的需要，并可能减轻除颤的一些有害副作用。这项工作也将有助于计算工具的发展，可用于在广泛的应用中找到最佳控制策略。