Optogenetics for cardiac pacing, resynchronization, and arrhythmia termination

Abstract Optogenetics is an emerging technique enabling optical control of a specific biological function in target cells by expression of light-sensitive proteins. The application of this technique in cardiac research, that is, cardiac optogenetics, mainly concerns the use of light-activated ion channels and pumps to manipulate the transmembrane potential of cardiomyocytes to control their excitability. Such control ranges from tailored stimulation to inhibition and offers novel and unique research possibilities regarding cardiac pacing, resynchronization and arrhythmia termination. Following a general introduction to optotools and gene transfer to the heart, these applications of optogenetics will be discussed in this chapter from mechanistic and translational points of view. Finally, key emerging innovations and future challenges regarding cardiac optogenetics will be outlined with the aim to provide a critical assessment of its clinical perspective.