Cardiac optogenetics: a decade of enlightenment

Nat Rev Cardiol. 2021 May;18(5):349-367. doi: 10.1038/s41569-020-00478-0. Epub 2020 Dec 18.


The electromechanical function of the heart involves complex, coordinated activity over time and space. Life-threatening cardiac arrhythmias arise from asynchrony in these space-time events; therefore, therapies for prevention and treatment require fundamental understanding and the ability to visualize, perturb and control cardiac activity. Optogenetics combines optical and molecular biology (genetic) approaches for light-enabled sensing and actuation of electrical activity with unprecedented spatiotemporal resolution and parallelism. The year 2020 marks a decade of developments in cardiac optogenetics since this technology was adopted from neuroscience and applied to the heart. In this Review, we appraise a decade of advances that define near-term (immediate) translation based on all-optical electrophysiology, including high-throughput screening, cardiotoxicity testing and personalized medicine assays, and long-term (aspirational) prospects for clinical translation of cardiac optogenetics, including new optical therapies for rhythm control. The main translational opportunities and challenges for optogenetics to be fully embraced in cardiology are also discussed.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Arrhythmias, Cardiac* / diagnostic imaging
  • Arrhythmias, Cardiac* / genetics
  • Arrhythmias, Cardiac* / therapy
  • Cardiac Electrophysiology* / methods
  • Cardiac Electrophysiology* / trends
  • Cardiac Imaging Techniques / instrumentation
  • Cardiac Imaging Techniques / methods
  • Cardiac Imaging Techniques / trends
  • Disease Models, Animal
  • Heart Diseases / diagnostic imaging
  • Heart Diseases / physiopathology
  • Heart Diseases / therapy
  • Humans
  • Opsins / pharmacology
  • Opsins / physiology
  • Optical Imaging / instrumentation
  • Optical Imaging / trends
  • Optogenetics* / instrumentation
  • Optogenetics* / methods
  • Optogenetics* / trends
  • Precision Medicine
  • Translational Research, Biomedical
  • Voltage-Sensitive Dye Imaging* / instrumentation
  • Voltage-Sensitive Dye Imaging* / methods
  • Voltage-Sensitive Dye Imaging* / trends


  • Opsins