Spatiotemporal evolution of ventricular fibrillation.

Autor: Witkowski FX; Department of Medicine, University of Alberta, Edmonton, Canada. fwitkows@gpu.srv.ualberta.ca, Leon LJ, Penkoske PA, Giles WR, Spano ML, Ditto WL, Winfree AT
Jazyk: angličtina
Zdroj: Nature [Nature] 1998 Mar 05; Vol. 392 (6671), pp. 78-82.
DOI: 10.1038/32170
Abstrakt: Sudden cardiac death is the leading cause of death in the industrialized world, with the majority of such tragedies being due to ventricular fibrillation. Ventricular fibrillation is a frenzied and irregular disturbance of the heart rhythm that quickly renders the heart incapable of sustaining life. Rotors, electrophysiological structures that emit rotating spiral waves, occur in several systems that all share with the heart the functional properties of excitability and refractoriness. These re-entrant waves, seen in numerical solutions of simplified models of cardiac tissue, may occur during ventricular tachycardias. It has been difficult to detect such forms of re-entry in fibrillating mammalian ventricles. Here we show that, in isolated perfused dog hearts, high spatial and temporal resolution mapping of optical transmembrane potentials can easily detect transiently erupting rotors during the early phase of ventricular fibrillation. This activity is characterized by a relatively high spatiotemporal cross-correlation. During this early fibrillatory interval, frequent wavefront collisions and wavebreak generation are also dominant features. Interestingly, this spatiotemporal pattern undergoes an evolution to a less highly spatially correlated mechanism that lacks the epicardial manifestations of rotors despite continued myocardial perfusion.
Databáze: MEDLINE