Patterns of wave break during ventricular fibrillation in isolated swine right ventricle

• Published in: American journal of physiology. Heart and circulatory physiology 2001-07, Vol.281 (1), p.H253-H265
• Main Authors: Lee, Moon-Hyoung, Qu, Zhilin, Fishbein, Gregory A, Lamp, Scott T, Chang, Eugene H, Ohara, Toshihiko, Voroshilovsky, Olga, Kil, Jong R, Hamzei, Ali R, Wang, Nina C, Lin, Shien-Fong, Weiss, James N, Garfinkel, Alan, Karagueuzian, Hrayr S, Chen, Peng-Sheng
• Format: Article
• Language: English
• Subjects: Action Potentials; Animals; Computer Simulation; Imaging, Three-Dimensional; In Vitro Techniques; Models, Cardiovascular; Optics and Photonics; Reaction Time; Signal Processing, Computer-Assisted; Swine; Ventricular Fibrillation - physiopathology; Ventricular Function, Right
• ISSN: 0363-6135; 1522-1539
• DOI: 10.1152/ajpheart.2001.281.1.h253

1  Division of Cardiology, Department of Medicine, Cedars-Sinai Medical Center, and 2  Division of Cardiology, Departments of Medicine and Physiology and Physiological Science, University of California School of Medicine, Los Angeles, California 90048; and 3  Department of Physics and Astronomy, Vanderbilt University, Nashville, Tennessee 37235 Several different patterns of wave break have been described by mapping of the tissue surface during fibrillation. However, it is not clear whether these surface patterns are caused by multiple distinct mechanisms or by a single mechanism. To determine the mechanism by which wave breaks are generated during ventricular fibrillation, we conducted optical mapping studies and single cell transmembrane potential recording in six isolated swine right ventricles (RV). Among 763 episodes of wave break (0.75 times · s 1 · cm 2 ), optical maps showed three patterns: 80% due to a wave front encountering the refractory wave back of another wave, 11.5% due to wave fronts passing perpendicular to each other, and 8.5% due to a new (target) wave arising just beyond the refractory tail of a previous wave. Computer simulations of scroll waves in three-dimensional tissue showed that these surface patterns could be attributed to two fundamental mechanisms: head-tail interactions and filament break. We conclude that during sustained ventricular fibrillation in swine RV, surface patterns of wave break are produced by two fundamental mechanisms: head-tail interaction between waves and filament break. reentry; mapping; electrophysiology; action potentials; restitution * M.-H. Lee and Z. Qu contributed equally to this study.