Spatial distribution of phase singularities in ventricular fibrillation

Miguel Valderrábano ¹, Peng-Sheng Chen , Shien-Fong Lin

⁰Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center and David Geffen School of Medicine, University of California Los Angeles, Calif 90048, USA.

Circulation +

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July 2, 2003

View abstract on PubMed

Summary

Phase singularities (PSs) in ventricular fibrillation (VF) are not random. They cluster along anatomical structures, influencing VF complexity and potentially guiding new sudden death therapies.

Area Of Science

Cardiac Electrophysiology
Computational Biology
Medical Imaging

Background

Ventricular fibrillation (VF) involves multiple excitation wavelets, but their organization is not fully understood.
Phase singularities (PSs) are key sources of VF, representing locations of ambiguous activation and underlying reentry.
Understanding PS formation mechanisms is crucial for developing effective sudden cardiac death therapies.

Purpose Of The Study

To investigate the spatial organization and distribution of phase singularities (PSs) during ventricular fibrillation (VF).
To determine the relationship between PS formation and cardiac anatomical structures.
To elucidate how PS behavior contributes to the complex activation patterns observed in VF.

Main Methods

Performed voltage, phase, and PS mapping in fibrillating ventricles using an automated PS detection algorithm on optically recorded signals.
Correlated PS locations with microscopic anatomical features, including fiber apposition and intramural vessels.
Analyzed PS life spans, incidence, and spatial distributions, including autocorrelation for behavioral analysis.

Main Results

Phase singularities (PSs) exhibited nonrandom clustering along epicardial vessels, endocardial trabeculae ridges, and papillary muscle insertions.
These anatomical structures acted as stabilizers, with PSs colocalizing to them showing significantly longer life spans (82.46 ms vs. 40.5 ms).
The right ventricular endocardium showed a higher PS incidence than the epicardium; irregular behavior was spatially restricted to anatomical heterogeneities.

Conclusions

Phase singularities (PSs) in VF are spatially organized and colocalize with normal anatomical heterogeneities.
Stable spatial distributions of PSs, coupled with variable PS behaviors and life spans, generate the complex, dynamic activation patterns characteristic of VF.
This nonrandom distribution provides insights into VF mechanisms and potential therapeutic targets.

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