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Related Experiment Videos

Virtual electrode polarization in the far field: implications for external defibrillation.

I R Efimov1, F Aguel, Y Cheng

  • 1Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. ire@po.cwru.edu

American Journal of Physiology. Heart and Circulatory Physiology
|September 20, 2000
PubMed
Summary

External defibrillation shocks can fail by creating virtual electrodes that induce cardiac arrhythmias. These virtual electrodes cause scroll waves, explaining defibrillation failure and vulnerability during external cardioversion.

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Area of Science:

  • Cardiac Electrophysiology
  • Computational Biology
  • Medical Devices

Background:

  • Implantable defibrillation therapy can fail, potentially due to virtual electrode-induced phase singularity mechanisms.
  • Understanding external defibrillation mechanisms is crucial for improving patient outcomes.

Purpose of the Study:

  • To identify mechanisms of vulnerability and defibrillation failure caused by externally applied shocks in vitro.
  • To investigate the role of virtual electrode polarization in shock-induced cardiac arrhythmias.

Main Methods:

  • Bidomain simulations of realistic rabbit heart geometry to predict passive polarization from external shocks.
  • Optical mapping of anterior epicardium electrical activity in Langendorff-perfused rabbit hearts during monophasic shocks.

Related Experiment Videos

  • Analysis of virtual electrode polarization and wave propagation patterns post-shock.

    • Main Results:

    • Virtual electrode polarization was observed after all applied shocks, consistent with bidomain simulations.
    • Arrhythmogenesis occurred during shocks, with new wave fronts initiating at polarization boundaries, leading to scroll wave formation.
    • Scroll waves with ribbon-shaped filaments were identified as a key mechanism in shock-induced arrhythmia.

    Conclusions:

    • Virtual electrode polarization is a critical factor in external defibrillation failure.
    • Shock-induced scroll waves, driven by virtual electrode polarization, explain cardiac vulnerability and defibrillation failure.
    • These findings provide insights into the fundamental mechanisms of external defibrillation.