Development of a Customizable Pacing Protocol to Induce Persistent Atrial Fibrillation in Swine

Bravo, F.; Ref, J.; Riemenschneider, J.; Lefkowitz, E.; Mostafizi, P.; Salciccioli, A.; DiPonio, S.; Grijalva, A.; Benson, D.; Tulino, A. S.; Pierce, M. K.; Goldman, S.; Moukabary, T.

doi:10.64898/2025.12.01.691684

bioRxiv · 10.64898/2025.12.01.691684

Development of a Customizable Pacing Protocol to Induce Persistent Atrial Fibrillation in Swine

Bravo, F.·Ref, J.·Riemenschneider, J.·Lefkowitz, E.·Mostafizi, P.·Salciccioli, A.·DiPonio, S.·Grijalva, A.·Benson, D.·Tulino, A. S.·Pierce, M. K.·Goldman, S.·Moukabary, T.

View original source ↗Export metadata ↓

Abstract

IntroductionPersistent atrial fibrillation (AFib) research is dependent on large animal models to understand pathogenesis and test new treatments and therapeutic techniques. While various methods have been established to induce persistent AFib in large animals, including electrical, surgical, pharmacological, and genetic approaches, each has distinct limitations. The most recent being the device industry no longer providing off-target rapid atrial pacing programs for use in animals. This challenge requires the development of a new accessible model of inducing atrial fibrillation in large animals. Methods UsedWe developed a wireless pacing system using a Raspberry Pi Pico W microcontroller (Pico) programmed for variable pacing frequencies. The device is powered by a subcutaneously implanted 9V battery. The Picos built-in Wi-Fi capabilities enable remote connection and real-time adjustment of pacing frequency output. This protocol describes a prospective study in which swine will undergo chronic right atrial pacing for 3-4 weeks to induce persistent AFib. We tested our device in a domestic swine. Vascular access was established through the left jugular vein and an active fixation pacing lead (Medtronic 5076) was implanted under fluoroscopic guidance in the right atrium. Proper lead positioning and pacing function were confirmed through electrocardiographic monitoring of both atrial and ventricular capture. Preliminary ResultsOscilloscope testing demonstrated frequency and voltage output concordant with the programmed frequencies while real-time adjustments were made through the Wi-Fi interface. A cardiac pacing wire was placed in the right ventricle then relocated to the right atrium and successful pacing with capture was verified using an electrocardiogram. ConclusionsThis protocol will provide a system capable of capturing atrial tissue with confirmed wireless power transfer capabilities that has minimal tissue heating and is physiologically safe. Combined with our literature review findings that electrical atrial pacing methods are most effective for inducing persistent AFib, our device provides researchers with the potential for an improved tool for creating large animal models of persistent AFib.

Explore related subjects

bioengineering Preprint

Keep this discovery

Explore connections, maps & timelines

BibTeX RIS

Bravo, F., Ref, J., Riemenschneider, J., Lefkowitz, E., Mostafizi, P., Salciccioli, A., DiPonio, S., Grijalva, A., Benson, D., Tulino, A. S., Pierce, M. K., Goldman, S., Moukabary, T.. 2025-12-03. Development of a Customizable Pacing Protocol to Induce Persistent Atrial Fibrillation in Swine. https://doi.org/10.64898/2025.12.01.691684

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related preprints

bioRxiv2026

Wall stiffening is a primary contributor to motility loss in Crohn's disease: an electromechanical modeling study

Fibrotic strictures are among the most disabling complications of Crohn's disease, permanently narrowing the bowel and impairing motility, yet no approved therapy reverses them. Chronic inflammation alters pacemaker-network coupling, smooth-muscle excitability, and calcium-dependent contractility, while fibrosis thickens the bowel wall, narrows the lumen, and changes tissue mechanics. The relative contributions of these coupled electrical, contractile, and structural alterations to motility loss remain unclear. To address this gap, we develop an integrated electromechanical finite-element framework for fibrostenosing Crohn's disease that couples a fibrosis-driven growth model with a FitzHugh-Nagumo electromechanical model. A full-factorial 25 design of experiments is used to quantify the relative effects of electrical diffusivity, excitation threshold, peak active stress, wall stiffness, and hypertrophic remodeling on cyclic lumen-volume deformation. Motility is quantified by the standard deviation of lumen volume over one contraction cycle. Within the parameter ranges examined, increased wall stiffness emerged as the dominant contributor to motility loss, followed by impaired smooth-muscle contractility. Changes in excitation threshold, hypertrophic remodeling, and electrical diffusivity produced substantially smaller effects. Pairwise interactions were small relative to the dominant main effects, indicating that the mechanisms contributed largely through their individual effects. Our findings suggest that limiting wall stiffening while preserving smooth-muscle contractile function may provide a therapeutic strategy for maintaining intestinal motility in fibrostenosing Crohn's disease.

bioengineering↗

bioRxiv2026

Lactate Receptor Activation Alleviates Senescence and Preserves Homeostasis of Aged Arteries

Arteries are among the first tissues to exhibit age-related dysfunction, yet the metabolic mechanisms driving vascular senescence remain poorly understood. Here, analysis of human aortic transcriptomic data identified HCAR1, encoding the lactate receptor GPR81, as one of the genes most significantly downregulated with age. We therefore investigated whether age-associated loss of GPR81 contributes to cellular senescence within the vessel wall. Senescent human endothelial cells and vascular smooth muscle cells accumulated neutral and oxidized lipids and exhibited increased labile iron and ferroptosis. Silencing GPR81 in early-passage cells recapitulated this metabolic phenotype together with multiple hallmarks of cellular senescence. Moreover, endothelial-specific deletion of GPR81 in young mice was sufficient to induce senescent cell accumulation, impaired lipid homeostasis, endothelial dysfunction, and elastin disorganization. Conversely, pharmacological activation of GPR81 with the agonist CHBA restored fatty acid metabolism, promoted glycolytic reprogramming, and attenuated ferroptotic stress and senescence-associated phenotypes. In lamin A knock-in (LAKI) progeroid mice, CHBA reduced arterial lipid accumulation and cellular senescence, shifted vascular cell composition toward a youthful state, improved endothelial integrity, and restored extracellular matrix homeostasis. Together, these findings identify age-associated loss of GPR81 as a driver of vascular metabolic dysfunction and cellular senescence and establish pharmacological GPR81 activation as a promising therapeutic strategy for preserving vascular homeostasis and mitigating age-associated cardiovascular disease.

bioengineering↗

bioRxiv2026

Targeted and bilateral blood flow monitoring in middle cerebral artery using diffuse correlation spectroscopy

Objective: To develop and validate a dual-probe Diffuse Correlation Spectroscopy (DCS) system for non-invasive and simultaneous, monitoring of cerebral blood flow (CBF) in the bilateral Middle Cerebral Artery (MCA) territories, and expanding the utility of conventional DCS limited to cortical-volume-based CBF measurements to vessel-specific cerebral perfusion monitoring. Methods: A dual-probe DCS system was designed for non-invasive monitoring of MCA-specific perfusion. Probe placement and protocol optimization study has been performed using anatomical landmarks, motor and speech activation tasks in healthy volunteers. System stability and repeatability were further evaluated in a pilot cohort of 30 healthy (age, 25{+/-}7 years) participants using optimized probe position and protocol. A bilateral MCA ischemic Lacunar Infract stroke case report also validated the feasibility of the system in clinical settings. Results: Measurements demonstrated superior sensitivity towards MCA-territory perfusion at targeted probe locations compared to off-MCA positions. In pilot cohort, significant increase of 30.34 {+/-} 21.56% and 36.48 {+/-} 21.22% in rCBF corresponding to hand squeeze and speech task respectively showed reproducible physiological responsiveness of the system (p<0.001). Measurement done on a patient with bilateral MCA ischemic Lacunar Infract stroke showed a significant change of 30% during speech for both the MCAs but no significant change is observed for hand squeeze tasks. Conclusion: The custom built dual-probe DCS system enables non-invasive, operator-independent, targeted and continuous monitoring of rCBF within bilateral MCA territories. Significance: This approach enables the potential use of DCS system for bilateral and vessel-specific monitoring of cerebral perfusion in the MCA territories.

bioengineering↗