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Related Experiment Videos

Ventricular fibrillation is not always due to multiple wavelet reentry

M J Janse1, F J Wilms-Schopman, R Coronel

  • 1Department of Clinical and Experimental Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands.

Journal of Cardiovascular Electrophysiology
|July 1, 1995
PubMed
Summary

Ventricular fibrillation (VF) can be caused by multiple reentrant waves or a single wandering reentrant wave. This study used cryoablation to simplify VF reentry patterns in pig hearts, revealing different wave dynamics.

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Area of Science:

  • Cardiovascular Physiology
  • Cardiac Electrophysiology
  • Arrhythmia Mechanisms

Background:

  • The precise mechanisms underlying ventricular fibrillation (VF) remain incompletely understood.
  • It is debated whether VF is exclusively caused by multiple wavelet reentry or if single wandering reentrant wavefronts can also be responsible.
  • Direct activation mapping of the entire ventricles during VF is technically challenging.

Purpose of the Study:

  • To investigate the reentry mechanisms of ventricular fibrillation (VF).
  • To differentiate between multiple wavelet reentry and single wandering reentrant wavefronts as causes of VF.
  • To analyze the impact of cryoablation on VF dynamics and activation patterns.

Main Methods:

  • Utilized isolated, Langendorff-perfused pig hearts.

Related Experiment Videos

  • Performed left and right endocardial cryoablation to create a thin subepicardial layer, simplifying tissue geometry.
  • Recorded epicardial activation patterns using 128 unipolar extracellular electrograms.
  • Induced VF via burst pacing and analyzed activation patterns before and after cryoablation.

    • Main Results:

    • Cryoablation successfully isolated the subepicardial layer, enabling 2D anisotropic propagation analysis.
    • VF inducibility and sustainability correlated with the mass of surviving subepicardium.
    • Intact ventricles showed up to six simultaneous wavefronts, indicative of multiple wavelet reentry.
    • The simplified 'frozen heart' model exhibited at most two, and sometimes only one, wandering reentrant wave.

    Conclusions:

    • Ventricular fibrillation (VF) can arise from various reentry mechanisms, including multiple wavelet reentry.
    • Single and dual wandering reentrant waves can also sustain VF, particularly in simplified cardiac tissue models.
    • The study demonstrates that different reentry patterns can produce similar extracellular waveforms during VF.