Complex dynamic order in ventricular fibrillation

Self-sustained circus movement of excitation has long been discussed as the underlying mechanism of ventricular fibrillation. This concept now appears to have found general acceptance. Mapping studies are very expensive and do not permit observations to be isolated from varying external influences. The authors have therefore used a simple cellular automation for studying the basic principles of excitation spreading during ventricular fibrillation under various conditions. Highly ordered spiral waves, described in other computer models, previously interpreted as fibrillation were encountered. Comparisons of pseudo-electrocardiograms created by the cellular automaton with original electrocardiographic recordings showed similarity in the time series and in fast Fouriér transformation. Modulation of refractory times often led to the termination of model fibrillation. Clinical evidence suggests that maintenance of the 1/f (RR-variability) variations produced by the autonomic nervous system exerts a protective effect on the evolution of ventricular fibrillation.