Low-energy termination of spiral turbulence in heterogeneous myocardium using circularly polarized electric fields

Circularly polarized electric fields (CPEF) represent a highly promising low-energy defibrillation approach, demonstrating exceptional efficacy in terminating life-threatening arrhythmias such as ventricular fibrillation while effectively mitigating the myocardial injury risks associated with conventional high-voltage defibrillation. This study provides an in-depth revelation of the mechanism by which CPEF induces excitation waves around naturally occurring heterogeneous defects within heart tissue, thereby suppressing spiral turbulence. Through numerical simulations based on the LR1 model and phase field method, we confirm that CPEF, due to its dynamic rotational properties, induces virtual electrode effects around various defects. In conditions of low strength, CPEF adaptively excites these defects, thereby achieving synchronized myocardial activation for defibrillation. In comparison with uniform electric fields (UEF), CPEF is more effective in suppressing spiral turbulence by inducing periodic excitation waves around defects with irregular geometries. These findings elucidate the biophysical principles underlying CPEF’s low-energy defibrillation capability, offering robust theoretical support for developing non-invasive antiarrhythmic therapies.