Dynamic mechanism for initiation of ventricular fibrillation in vivo.

Circulation
Anna R M GelzerRobert F Gilmour

Abstract

Dynamically induced heterogeneities of repolarization may lead to wave-front destabilizations and initiation of ventricular fibrillation (VF). In a computer modeling study, we demonstrated that specific sequences of premature stimuli maximized dynamically induced spatial dispersion of refractoriness and predisposed the heart to the development of conduction block. The purpose of this study was to determine whether the computer model results pertained to the initiation of VF in dogs in vivo. Monophasic action potentials were recorded from right and left ventricular endocardium in anesthetized beagle dogs (n=11) in vivo. Restitution of action potential duration and conduction time and the effective refractory period after delivery of the basic stimulus (S(1)) and each of 3 premature stimuli (S(2), S(3), S(4)) were determined at baseline and during verapamil infusion. The effective refractory period data were used to determine the interstimulus intervals for a sequence of 4 premature stimuli (S(2)S(3)S(4)S(5)=CL(VF)) for which the computer model predicted maximal spatial dispersion of refractoriness. Delivery of CL(VF) was associated with discordant action potential duration alternans and induction of VF in all dogs. Verapamil dec...Continue Reading

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Citations

Apr 3, 2012·American Journal of Physiology. Heart and Circulatory Physiology·Elizabeth M CherryRobert F Gilmour
Jun 26, 2012·American Journal of Physiology. Heart and Circulatory Physiology·Yves T WangYuanna Cheng
Mar 1, 2014·Journal of Theoretical Biology·Stephen D McIntyreElena G Tolkacheva
Oct 1, 2014·Physics Reports·Zhilin QuJames N Weiss
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Mar 16, 2011·IEEE Transactions on Bio-medical Engineering·Niels F Otani
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Nov 27, 2015·The Journal of Physiology·Sanjiv M Narayan, Junaid A B Zaman
Dec 24, 2014·Circulation Research·Giedrius Kanaporis, Lothar A Blatter
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Oct 15, 2008·Physical Review. E, Statistical, Nonlinear, and Soft Matter Physics·Fernando Siso-NadalJeffrey J Fox

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