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Related Experiment Videos

Locally propagated activation immediately after internal defibrillation

N Chattipakorn1, B H KenKnight, J M Rogers

  • 1Department of Physiology and Biophysics, University of Alabama at Birmingham, USA.

Circulation
|May 13, 1998
PubMed
Summary

Electrical mapping reveals that the interval between defibrillation shock and global ventricular activation is not silent. Locally propagated activations (LPAs) occur, influencing subsequent wave propagation and potentially impacting defibrillation success.

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Area of Science:

  • Cardiovascular Electrophysiology
  • Cardiac Arrhythmia Mechanisms
  • Defibrillation Science

Background:

  • Electrical mapping studies show a 40-100 ms interval between defibrillation shock and global ventricular activation (GPA).
  • The existence and nature of activation within this interval remain incompletely understood.

Purpose of the Study:

  • To investigate whether activation occurs locally but is blocked before global propagation (locally propagated activation, LPA).
  • To characterize the timing and impact of LPAs on subsequent cardiac activation patterns after defibrillation shocks.

Main Methods:

  • Utilized a 504-electrode epicardial sock for high-resolution mapping in anesthetized pigs.
  • Delivered biphasic shocks near the defibrillation threshold (DFT) and analyzed activation sequences.

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  • Defined local activation based on dV/dt criteria and used animated displays to visualize wave-front interactions.

    • Main Results:

    • Locally propagated activations (LPAs) were observed in 40 out of 50 shocks, involving an average of 2 electrodes.
    • LPAs occurred earlier after failed (35±8 ms) than successful (41±16 ms) shocks.
    • The GPA front was blocked by the LPA region more frequently when the time from LPA onset to GPA arrival was shorter (32±12 ms).

    Conclusions:

    • Locally propagated activations (LPAs) are present after both successful and failed defibrillation shocks near the DFT.
    • The interval between shock delivery and global ventricular activation is not electrically silent, with LPAs playing a role in wave propagation dynamics.