See the light: can optogenetics restore healthy heartbeats? And, if it can, is it really worth the effort?

Abstract

Cardiac optogenetics is an exciting new methodology in which light-sensitive ion channels are expressed in heart tissue to enable optical control of bioelectricity. This technology has the potential to open new avenues for safely and effectively treating rhythm disorders in the heart with gentle beams of light. Recently, we developed a comprehensive framework for modeling cardiac optogenetics. Simulations conducted in this platform will provide insights to guide in vitro investigation and steer the development of therapeutic applications – these are the first steps toward clinical translation. In this editorial, we review literature relevant to light-sensitive protein delivery and intracardiac illumination to provide a holistic feasibility assessment for optogenetics-based arrhythmia termination therapy. We then draw on examples from computational work to show that the optical control paradigm has undeniable advantages that cannot be attained with conventional electrotherapy. Hence, we argue that cardiac optogenetics is more than a flashy substitute for current approaches.

Keywords::

• arrhythmia
• cardioversion
• cell therapy
• defibrillation
• direct His-bundle pacing
• gene therapy
• optogenetics

Acknowledgements

The authors wish to thank A Klimas for illuminating discussions regarding intracardiac light delivery.

Financial & competing interests disclosure

The authors were supported by a postdoctoral fellowship from NSERC of Canada, US NIH grants R01-HL111649 and R01-HL103428, and US NSF grant NSF-CDI-1124804. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.