Terminating spiral waves with a single designed stimulus: Teleportation as the mechanism for defibrillation

TL;DR

This paper introduces a universal topological mechanism for terminating spiral waves in excitable media, enabling the design of a single minimal stimulus for effective defibrillation across various cardiac models.

Contribution

It presents a novel topological framework that explains defibrillation success and guides the creation of minimal stimuli for turbulent cardiac states.

Findings

Universal mechanism for spiral wave termination identified

Single minimal stimulus can defibrillate turbulent states

Applicable across multiple cardiac tissue models

Abstract

We demonstrate a universal mechanism for terminating spiral waves in excitable media using an established topological framework. This mechanism dictates whether high- or low-energy defibrillation shocks succeed or fail. Furthermore, this mechanism allows for the design of a single minimal stimulus capable of defibrillating, at any time, turbulent states driven by multiple spiral waves. We demonstrate this method in a variety of computational models of cardiac tissue ranging from simple to detailed human models. The theory described here shows how this mechanism underlies all successful defibrillation and can be used to further develop existing and future low-energy defibrillation strategies.