The Importance of Purkinje Activation in Long Duration Ventricular Fibrillation

Background The mechanisms that maintain long duration ventricular fibrillation (LDVF) are unclear. The difference in distribution of the Purkinje system in dogs and pigs was explored to determine if Purkinje activation propagates to stimulate working myocardium (WM) during LDVF and WM pacing. Method...

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Bibliographic Details
Published in:Journal of the American Heart Association 2014-02, Vol.3 (1), p.e000495-n/a
Main Authors: Huang, Jian, Dosdall, Derek J., Cheng, Kang‐An, Li, Li, Rogers, Jack M., Ideker, Raymond E.
Format: Article
Language:English
Subjects:
Action Potentials
Animals
arrhythmia (mechanisms)
Cardiac Pacing, Artificial
Disease Models, Animal
Dogs
Endocardium - physiopathology
Epicardial Mapping - instrumentation
long duration ventricular fibrillation
Microelectrodes
Original Research
Pericardium - physiopathology
Purkinje Fibers - physiopathology
Swine
Time Factors
ventricular arrhythmia
Ventricular Fibrillation - diagnosis
Ventricular Fibrillation - etiology
Ventricular Fibrillation - physiopathology
Ventricular Fibrillation - therapy
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Summary:Background The mechanisms that maintain long duration ventricular fibrillation (LDVF) are unclear. The difference in distribution of the Purkinje system in dogs and pigs was explored to determine if Purkinje activation propagates to stimulate working myocardium (WM) during LDVF and WM pacing. Methods and Results In‐vivo extracellular recordings were made from 1044 intramural plunge and epicardial plaque electrodes in 6 pig and 6 dog hearts. Sinus activation propagated sequentially from the endocardium to the epicardium in dogs but not pigs. During epicardial pacing, activation propagated along the endocardium and traversed the LV wall almost parallel to the epicardium in dogs, but in pigs propagated away from the pacing site approximately perpendicular to the epicardium. After 1 minute of VF, activation rate near the endocardium was significantly faster than near the epicardium in dogs (P0.05). From 2 to 10 minutes of LDVF, recordings exhibiting Purkinje activations were near the endocardium in dogs (P
ISSN:2047-9980
2047-9980
DOI:10.1161/JAHA.113.000495