期刊
PROGRESS IN BIOPHYSICS & MOLECULAR BIOLOGY
卷 90, 期 1-3, 页码 399-413出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.pbiomolbio.2005.06.008
关键词
external shock; reentry induction; electrode polarity; vulnerability
资金
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL067322] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF BIOMEDICAL IMAGING AND BIOENGINEERING [P20EB001432] Funding Source: NIH RePORTER
- Medical Research Council [G0700278] Funding Source: Medline
- NHLBI NIH HHS [HL067322, HL063196] Funding Source: Medline
- NIBIB NIH HHS [P20 EB001432] Funding Source: Medline
Despite the fact that elucidating the mechanisms of cardiac vulnerability to electric shocks is crucial to understanding why defibrillation shocks fail, important aspects of cardiac vulnerability remain unknown. This research utilizes a novel anatomically based bidomain finite-element model of the rabbit ventricles to investigate the effect of shock polarity reversal on the reentrant activity induced by an external defibrillation-strength shock in the paced ventricles. The specific goal of the study is to examine how differences between left and right ventricular chamber anatomy result in differences in the types of reentrant circuits established by the shock. Truncated exponential monophasic shocks of duration 8 ms were delivered via two external electrodes at various timings. Vulnerability grids were constructed for shocks of reversed polarity (referred to as RV- or LV- when either the RV or the LV electrode is a cathode). Our results demonstrate that reversing electrode polarity from RV- to LV- changes the dominant type of post-shock reentry: it is figure-of-eight for RV- and quatrefoil for LV- shocks. Differences in secondary types of post-shock arrhythmia also occur following shock polarity reversal. These effects of polarity reversal are primarily due to the fact that the LV wall is thicker than the RV, resulting in a post-shock excitable gap that is predominantly within the LV wall for RV- shocks and in the septum for LV- shocks. (c) 2005 Elsevier Ltd. All rights reserved.
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