Related Experiment Video
Updated: Apr 15, 2026
Recapitulation of an Ion Channel IV Curve Using Frequency Components
Published on: February 8, 2011
An activation-repolarization time metric to predict localized regions of high susceptibility to reentry
Nicholas Child1, Martin J Bishop1, Ben Hanson2
1Division of Imaging Sciences, King's College London, London, United Kingdom.
Background:
Initiation of reentrant ventricular tachycardia (VT) involves complex interactions between front and tail of the activation wave. Recent experimental work has identified the time interval between S2 repolarization proximal to a line of functional block and S2 activation at the adjacent distal side as a critical determinant of reentry.
Objectives:
We hypothesized that (1) an algorithm could be developed to generate a spatial map of this interval ("reentry vulnerability index" [RVI]), (2) this would accurately identify a site of reentry without the need to actually induce the arrhythmia, and (3) it would be possible to generate an RVI map in patients during routine clinical procedures.
Methods:
An algorithm was developed that calculated RVI between all pairs of electrodes within a given radius.
Results:
The algorithm successfully identified the region with increased susceptibility to reentry in an established Langendorff pig heart model and the site of reentry and rotor formation in an optically mapped sheep ventricular preparation and computational simulations. The feasibility of RVI mapping was evaluated during a clinical procedure by coregistering with cardiac anatomy and physiology of a patient undergoing VT ablation.
Conclusion:
We developed an algorithm to calculate a reentry vulnerability index from intervals between local repolarization and activation. The algorithm accurately identified the region of reentry in 2 animal models of functional reentry. The clinical application was demonstrated in a patient with VT and identified the area of reentry without the need of inducing the arrhythmia.
Related Concept Videos
01:30Cardiac Action Potential
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
01:28Action Potential: Phases of Stimulation
Resting Phase:
In this phase, the cell's membrane is at its resting potential, typically around -70 millivolts (mV) for neurons. Inside the cell, there is a higher concentration of potassium ions (K+) and a lower concentration of sodium ions (Na+). Voltage-gated sodium channels are closed, and...
01:23Propagation of Action Potentials
Neurons (nerve cells) have a resting membrane potential, with a slightly negative charge inside compared to outside. This is maintained by ion channels, such as sodium (Na+) and potassium (K+) channels, which control the flow of ions. When a stimulus, like a touch or a signal from another neuron, triggers the neuron, sodium channels open, allowing sodium ions to...
01:15Resting Potential Decay
01:15Resting Potential Decay
At rest, the K+ is the main ion that moves across the membrane...
01:24Resting Membrane Potential
The Inside of a Neuron is More Negative
The membrane potential of a cell can be measured by inserting a microelectrode into a cell and comparing the charge to a reference electrode in the extracellular fluid. The...