Spatiotemporal Control of Human Cardiac Tissue Through Optogenetics

Cardiac arrhythmias are caused by disordered propagation of electrical activity. Progress in understanding and controlling arrhythmias requires novel methods to characterize and control the spatiotemporal propagation of electrical activity. We used patterned illumination of cardiomyocytes derived from optogenetic human induced pluripotent stem cells to create dynamic conduction blocks, and to test spatially extended control schemes. Using this model, we demonstrated the ability to initiate, circumscribe, relocate, and terminate pathologic spiral waves that drive many arrhythmias. When cells were derived from patients with long QT syndrome, longer action potential durations made spiral waves more resistant to termination. This work lays the foundation for personalized models of cardiac injury and disease, and the development of tailored approaches to the management of arrhythmias.