Imaging ventricular fibrillation

Ventricular fibrillation (VF) had been traditionally considered as a highly disorganized process of random electrical activity emanating from multiple, short-lived, reentrant electrical waves. It is the incessant breakup of wave fronts and the creation of new daughter waves (wavebreaks) that perpetuate VF. Other studies described VF as a process with a substantial degree of structure embedded in seemingly random events where VF is spatially organized as a small number of relatively large domains, each with a single dominant frequency. Ventricular fibrillation is then driven by the domain with the highest activation frequency representing a "mother rotor" that drives the surrounding myocardium except at boundaries with more refractory tissues. Voltage-sensitive dyes and optical mapping provide a powerful technique that has been extensively applied to study the structure and organization of VF and has revealed how cellular properties, fiber orientation, and metabolism influence VF. This brief review will discuss signal processing methods used to investigate mechanisms underlying VF, namely, (a) fast Fourier transform, (b) time-frequency domain analysis, (c) time-lag correlation, (d) mutual information analysis, and (e) phase reconstruction techniques to identify phase singularities and wavebreak locations. In addition, several cellular properties that have been shown to influence the structure of VF such as (a) the dispersion of repolarization, (b) the low tonicity/osmolarity, and (c) the amplitude of K(+) currents will be discussed as determinants of VF. Finally, recent image analysis routines were used to identify wavebreak sites and revealed that wavebreaks are caused by abrupt spatial dispersion of voltage (V(m)) oscillations.