Heart Rhythm
Volume 7, Issue 7 , Pages 953-961 , July 2010

Tunnel propagation following defibrillation with ICD shocks: Hidden postshock activations in the left ventricular wall underlie isoelectric window

  • Jason Constantino, BS

      Affiliations

    • Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
    • ,
  • Yun Long, MS

      Affiliations

    • Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
    • ,
  • Takashi Ashihara, MD, PhD

      Affiliations

    • Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan
    • ,
  • Natalia A. Trayanova, PhD, FHRS

      Affiliations

    • Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
    • Corresponding Author InformationAddress reprint requests and correspondence: Dr. Natalia Trayanova, 3400 North Charles Street, CSEB 216, Baltimore, Maryland 21218

Received 27 January 2010 ,Accepted 20 March 2010.

References 

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  2. Chen PS, Shibata N, Dixon EG, et al. Activation during ventricular defibrillation in open-chest dogs (Evidence of complete cessation and regeneration of ventricular fibrillation after unsuccessful shocks). J Clin Invest. 1986;77:810–823
  3. Chattipakorn N, Fotuhi PC, Chattipakorn SC, Ideker RE. Three-dimensional mapping of earliest activation after near-threshold ventricular defibrillation shocks. J Cardiovasc Electrophysiol. 2003;14:65–69
  4. Chattipakorn N, Banville I, Gray RA, Ideker RE. Mechanism of ventricular defibrillation for near-defibrillation threshold shocks: a whole-heart optical mapping study in swine. Circulation. 2001;104:1313–1319
  5. Trayanova NA, Gray RA, Bourn DW, Eason JC. Virtual electrode-induced positive and negative graded responses: new insights into fibrillation induction and defibrillation. J Cardiovasc Electrophysiol. 2003;14:756–763
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  8. Ashihara T, Constantino J, Trayanova NA. Tunnel propagation of postshock activations as a hypothesis for fibrillation induction and isoelectric window. Circ Res. 2008;102:737–745
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  15. Entcheva E, Trayanova NA, Claydon FJ. Patterns of and mechanisms for shock-induced polarization in the heart: a bidomain analysis. IEEE Trans Biomed Eng. 1999;46:260–270
  16. Anderson C, Trayanova NA, Skouibine K. Termination of spiral waves with biphasic shocks: role of virtual electrode polarization. J Cardiovasc Electrophysiol. 2000;11:1386–1396
  17. Hillebrenner MG, Eason JC, Trayanova NA. Mechanistic inquiry into decrease in probability of defibrillation success with increase in complexity of preshock reentrant activity. Am J Physiol Heart Circ Physiol. 2004;286:H909–H917
  18. Efimov IR, Cheng Y, Van Wagoner DR, Mazgalev T, Tchou PJ. Virtual electrode-induced phase singularity: a basic mechanism of defibrillation failure. Circ Res. 1998;82:918–925
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 Supported by National Institutes of Health grants R01-HL082729 and R01-HL067322 to Dr. Trayanova.

 Constantino and Long contributed equally to this work.

PII: S1547-5271(10)00268-7

doi: 10.1016/j.hrthm.2010.03.026

Heart Rhythm
Volume 7, Issue 7 , Pages 953-961 , July 2010

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