Mechanisms of defibrillation

Electrical shock has been the one effective treatment for ventricular fibrillation for several decades. With the advancement of electrical and optical mapping techniques, histology, and computer modeling, the mechanisms responsible for defibrillation are now coming to light. In this review, we discu...

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Bibliographic Details
Published in:Annual review of biomedical engineering 2010-08, Vol.12 (1), p.233-258
Main Authors: Dosdall, Derek J, Fast, Vladimir G, Ideker, Raymond E
Format: Article
Language:English
Subjects:
Animals
Arrhythmias, Cardiac - physiopathology
Arrhythmias, Cardiac - therapy
Dogs
Electric Countershock
Electrodes
Electroporation
Heart - physiology
Heart - physiopathology
Humans
Models, Cardiovascular
Rabbits
Swine
Ventricular Fibrillation - physiopathology
Ventricular Fibrillation - therapy
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Summary:Electrical shock has been the one effective treatment for ventricular fibrillation for several decades. With the advancement of electrical and optical mapping techniques, histology, and computer modeling, the mechanisms responsible for defibrillation are now coming to light. In this review, we discuss recent work that demonstrates the various mechanisms responsible for defibrillation. On the cellular level, membrane depolarization and electroporation affect defibrillation outcome. Cell bundles and collagenous septae are secondary sources and cause virtual electrodes at sites far from shocking electrodes. On the whole-heart level, shock field gradient and critical points determine whether a shock is successful or whether reentry causes initiation and continuation of fibrillation.
ISSN:1523-9829
1545-4274
DOI:10.1146/annurev-bioeng-070909-105305