A new study developed an imaging technique, a person dies of sudden cardiac arrest or fibrillation, the most common cause of death worldwide. When the heart muscle no longer contracts in a coordinated manner, but simply flutters or twitches a condition referred to medically as "fibrillation" it is a highly life-threatening situation.

If the ventricles, the main chambers of the heart, twitch in this disorderly way, there is just one opportunity for medical intervention: the heart must be defibrillated within a few minutes with a strong electrical shock, which is very painful and can damage the heart's tissue.

Fibrillation of the atria, on the other hand, is not directly life-threatening; however, if left untreated it can have dire consequences. For over 100 years, researchers have sought to understand the mechanisms behind fibrillation to improve treatment options. "The key to a better understanding of fibrillation lies in a new, high-resolution imaging technique that allows processes inside the heart muscle to be observed," says Stefan Luther.

The new diagnostic method will help to make the treatment of ventricular fibrillation and possibly also atrial fibrillation more effective. The improved understanding of fibrillation, which can be achieved with the procedure, could help to advance the development of novel defibrillation techniques.

In low-energy defibrillation. With the new form of ultrasound imaging, researchers could learn how to use low-energy pulses to restore normal heart rhythm.

In the future, cardiologists will be able to see exactly where pathological foci of excitation need to be removed by ablation. The new ultrasound method may also be helpful in the research, diagnosis and treatment of heart failure, during which the myocardial cells do not work effectively as their coordinated contractile movements are disrupted.

Electrical waves cause mechanical contractions of the heart

Every heartbeat is triggered by electrical waves of excitation that propagate through the myocardium at high speed and cause the myocardial cells to contract. If these waves become turbulent, the result is cardiac arrhythmia. Doctors have long known that in cardiac arrhythmias, rotational electrical waves of excitation swirl through the heart muscle.

Until now, their investigations of cardiac arrhythmias have focussed on such electrical vortices. However, they have not been able to ascertain a full picture of the dynamics, neither in the laboratory nor in the clinical setting. Stefan Luther is certain of one thing: "Peering deeply into the inner dynamics of the heart marks a milestone in heart research and will decisively shape our understanding and treatment of heart disease in the future."

In the future, this newly developed imaging technique may help medical doctors to image and thus identify heart rhythm disorders, helping them to better understand cardiac disease and further develop new, more effective methods for treatment.