Wearable-based shock-free control of cardiac rhythm for acute ambulatory cardioversion of atrial fibrillation
V Portero, S Deng, B L Den Ouden, C I Bart, W H Bax, T J C De Coster, S O Dekker, A Ivanova, J Zhang, A Nobacht, G J Boink, B Ordog, M Palmen, A A F De Vries, D A PijnappelsAbstract
Wearable devices have revolutionized health monitoring, yet their potential for delivering corrective actions remains largely uncharted. This is critical for conditions where timely interventions can be life-changing, such as for atrial fibrillation (AF), the most prevalent cardiac arrhythmia.
We here introduce a wearable, closed-loop system integrating microelectronics and optogenetics to realize immediate shock-free AF termination upon detection. This is demonstrated in freely moving rats while they are eating, sleeping and walking undisturbed. Translational studies confirm optogenetic control of cardiac rhythm in human atrial tissue, AF termination in true human atrium-sized models, and successful operation of the full system in the human body.
These findings offer a transformative perspective for on-demand next-generation personalized therapeutics, while opening new research avenues into disease progression and treatment over time.Schematic experimental procedure