Document Detail

Panoramic optical mapping shows wavebreak at a consistent anatomical site at the onset of ventricular fibrillation.
MedLine Citation:
PMID:  22144474     Owner:  NLM     Status:  MEDLINE    
AIMS: The first seconds of ventricular fibrillation (VF) are well organized and can consist of just one to two rotating waves (rotors). New rotors are spawned when local propagation block causes wave fragmentation. We hypothesized that this process, which leads to fully developed VF, begins at a consistent anatomic site.
METHODS AND RESULTS: We initiated VF with a stimulus timed to the local T-wave in 10 isolated pig hearts. Hearts were stained with a voltage-sensitive dye and four video cameras recorded electrical propagation panoramically across the epicardium. In each VF episode, we identified the position of the first wavebreak event that produced new rotor(s) that persisted for at least one cycle. The first such wavebreak occurred along the anterior right ventricular insertion (ARVI) in 26 of 32 VF episodes. In these episodes, wavebreak sites were 6 ± 4 mm from the midline of the ARVI. In the remaining 6 episodes, wavebreak sites were 24 ± 5 mm from the midline on either the LV or RV. During rapid pacing, conduction speed was locally depressed at the ARVI when waves crossed parallel to the midline. Action potential duration (APD) was slightly longer (2.2 ± 2.1 ms) at the ARVI compared with other sites (P< 0.01). Temporal APD alternans were small and not unique to the break site, suggesting that dynamic APD properties were not the cause of wavebreak.
CONCLUSION: The ARVI is the dominant site for wavebreak at the onset of VF in normal myocardium. This may be due to the anatomic complexity of the region.
Elliot B Bourgeois; Hugh D Reeves; Gregory P Walcott; Jack M Rogers
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-12-05
Journal Detail:
Title:  Cardiovascular research     Volume:  93     ISSN:  1755-3245     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-17     Completed Date:  2012-05-21     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  272-9     Citation Subset:  IM    
Department of Biomedical Engineering, The University of Alabama at Birmingham, 1670 University Blvd., Volker Hall B140, Birmingham, AL 35294, USA.
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MeSH Terms
Action Potentials
Cardiac Pacing, Artificial
Heart Conduction System / physiopathology
Ventricular Fibrillation / etiology*,  physiopathology
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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