Heart Rhythm
Volume 4, Issue 8 , Pages 1057-1068 , August 2007

Spatially discordant voltage alternans cause wavebreaks in ventricular fibrillation

  • Bum-Rak Choi, PhD

      Affiliations

    • Department of Cell Biology and Physiology, University of Pittsburgh, Pittsburgh, Pennsylvania
    • Dr. Choi’s current addresses is Cardiovascular Research Center, Rhode Island Hospital & Brown Medical School, Providence, Rhode Island 02903.
    • Corresponding Author InformationAddress reprint requests and correspondence: Dr. Bum-Rak Choi, Cardiovascular Research Center, Rhode Island Hospital & Brown Medical School, One Hoppin Street, Providence, Rhode Island 02903.
    • ,
  • Woncheol Jang, PhD

      Affiliations

    • Department of Statistics, Carnegie Mellon University, Pittsburgh, Pennsylvania
    • ,
  • Guy Salama, PhD

      Affiliations

    • Department of Cell Biology and Physiology, University of Pittsburgh, Pittsburgh, Pennsylvania
    • Corresponding Author InformationDr. Guy Salama, University of Pittsburgh, School of Medicine, Department of Cell Biology and Physiology, 200 Lothrop Street, Pittsburgh, Pennsylvania 15261.

Received 11 August 2006 ,Accepted 28 March 2007.

References 

  1. Chen PS, Garfinkel A, Weiss JN, Karagueuzian HS. Spirals, chaos, and new mechanisms of wave propagation. Pacing Clin Electrophysiol. 1997;20:414–421
  2. Garfinkel A, Chen PS, Walter DO, Karagueuzian HS, Kogan B, Evans SJ, et al. Quasiperiodicity and chaos in cardiac fibrillation. J Clin Invest. 1997;99:305–314
  3. Derksen R, van Rijen HV, Wilders R, Tasseron S, Hauer RN, Rutten WL, et al. Tissue discontinuities affect conduction velocity restitution: a mechanism by which structural barriers may promote wave break. Circulation. 2003;108:882–888
  4. Wu TJ, Ong JJ, Hwang C, Lee JJ, Fishbein MC, Czer L, et al. Characteristics of wave fronts during ventricular fibrillation in human hearts with dilated cardiomyopathy: role of increased fibrosis in the generation of reentry. J Am Coll Cardiol. 1998;32:187–196
  5. Starobin JM, Zilberter YI, Rusnak EM, Starmer CF. Wavelet formation in excitable cardiac tissue: the role of wavefront-obstacle interactions in initiating high-frequency fibrillatory-like arrhythmias. Biophys J. 1996;70:581–594
  6. Saumarez RC. Electrophysiological investigation of patients with hypertrophic cardiomyopathy (Evidence that slowed intraventricular conduction is associated with an increased risk of sudden death). Br Heart J. 1994;72:S19–S23
  7. Valderrabano M, Chen PS, Lin SF. Spatial distribution of phase singularities in ventricular fibrillation. Circulation. 2003;108:354–359
  8. Nerbonne JM. Studying cardiac arrhythmias in the mouse—a reasonable model for probing mechanisms?. Trends Cardiovasc Med. 2004;14:83–93
  9. Antzelevitch C, Yan GX, Shimizu W. Transmural dispersion of repolarization and arrhythmogenicity: the Brugada syndrome versus the long QT syndrome. J Electrocardiol. 1999;32(Suppl):158–165
  10. Yao JA, Jiang M, Fan JS, Zhou YY, Tseng GN. Heterogeneous changes in K currents in rat ventricles three days after myocardial infarction. Cardiovasc Res. 1999;44:132–145
  11. Pinto JM, Boyden PA. Electrical remodeling in ischemia and infarction. Cardiovasc Res. 1999;42:284–297
  12. Gilmour RF, Chialvo DR. Electrical restitution, critical mass, and the riddle of fibrillation. J Cardiovasc Electrophysiol. 1999;10:1087–1089
  13. Qu Z, Weiss JN, Garfinkel A. Cardiac electrical restitution properties and stability of reentrant spiral waves: a simulation study. Am J Physiol. 1999;276:H269–H283
  14. Fox JJ, McHarg JL, Gilmour RF. Ionic mechanism of electrical alternans. Am J Physiol Heart Circ Physiol. 2002;282:H516–H530
  15. Banville I, Chattipakorn N, Gray RA. Restitution dynamics during pacing and arrhythmias in isolated pig hearts. J Cardiovasc Electrophysiol. 2004;15:455–463
  16. Franz MR. The electrical restitution curve revisited: steep or flat slope—which is better?. J Cardiovasc Electrophysiol. 2003;14:S140–S147
  17. Choi BR, Nho W, Liu T, Salama G. Life span of ventricular fibrillation frequencies. Circ Res. 2002;91:339–345
  18. Gray RA, Pertsov AM, Jalife J. Spatial and temporal organization during cardiac fibrillation. Nature. 1998;392:75–78
  19. Rogers JM, Huang J, Smith WM, Ideker RE. Incidence, evolution, and spatial distribution of functional reentry during ventricular fibrillation in pigs. Circ Res. 1999;84:945–954
  20. Gonzalez RC, Woods RE. Digital Image Processing. Second Edition. Upper Saddle River, NJ: Prentice Hall; 2002;
  21. Choi BR, Hatton WJ, Hume JR, Liu T, Salama G. Low osmolarity transforms ventricular fibrillation from complex to highly organized, with a dominant high-frequency source. Heart Rhythm. 2006;3:1210–1220
  22. Bray MA, Lin SF, Aliev RR, Roth BJ, Wikswo JP. Experimental and theoretical analysis of phase singularity dynamics in cardiac tissue. J Cardiovasc Electrophysiol. 2001;12:716–722
  23. Zou R, Kneller J, Leon LJ, Nattel S. Substrate size as a determinant of fibrillatory activity maintenance in a mathematical model of canine atrium. Am J Physiol Heart Circ Physiol. 2005;289:H1002–H1012
  24. Efimov IR, Huang DT, Rendt JM, Salama G. Optical mapping of repolarization and refractoriness from intact hearts. Circulation. 1994;90:1469–1480
  25. Ripley BD. Statistical Inference for Spatial Processes. Cambridge: Cambridge University Press; 1988;
  26. Jammalamadaka SR, SenGupta A. Topics in Circular Statistics. Singapore: World Scientific Publishing; 2001;
  27. Berenfeld O, Persov AM, Jalife J. What is the organization of waves in ventricular fibrillation?. Circ Res. 2001;89:e22
  28. Choi BR, Liu T, Salama G. The distribution of refractory periods influences the dynamics of ventricular fibrillation. Circ Res. 2001;88:E49–E58
  29. Liu YB, Peter A, Lamp ST, Weiss JN, Chen PS, Lin SF. Spatiotemporal correlation between phase singularities and wavebreaks during ventricular fibrillation. J Cardiovasc Electrophysiol. 2003;14:1103–1109
  30. Chen J, Mandapati R, Berenfeld O, Skanes AC, Jalife J. High-frequency periodic sources underlie ventricular fibrillation in the isolated rabbit heart. Circ Res. 2000;86:86–93
  31. Lee MH, Qu Z, Fishbein GA, Lamp ST, Chang EH, Ohara T, et al. Patterns of wave break during ventricular fibrillation in isolated swine right ventricle. Am J Physiol Heart Circ Physiol. 2001;281:H253–H265
  32. Karma A. Electrical alternans and spiral wave breakup in cardiac tissue. Chaos. 1994;4:461–472
  33. Konta T, Ikeda K, Yamaki M, Nakamura K, Honma K, Kubota I, et al. Significance of discordant ST alternans in ventricular fibrillation. Circulation. 1990;82:2185–2189
  34. Gilmore JP, Powell WJ, Graham TP, Clancy RL. Discordant pulsus alternans in dog heart. Am J Physiol. 1967;212:1515–1518
  35. Watanabe MA, Fenton FH, Evans SJ, Hastings HM, Karma A. Mechanisms for discordant alternans. J Cardiovasc Electrophysiol. 2001;12:196–206
  36. Huang J, Zhou X, Smith WM, Ideker RE. Restitution properties during ventricular fibrillation in the in situ swine heart. Circulation. 2004;110:3161–3167
  37. Samie FH, Berenfeld O, Anumonwo J, Mironov SF, Udassi S, Beaumont J, et al. Rectification of the background potassium current: a determinant of rotor dynamics in ventricular fibrillation. Circ Res. 2001;89:1216–1223
  38. Valderrabano M, Yang J, Omichi C, Kil J, Lamp ST, Qu Z, et al. Frequency analysis of ventricular fibrillation in Swine ventricles. Circ Res. 2002;90:213–222
  39. Chen PS, Wu TJ, Ting CT, Karagueuzian HS, Garfinkel A, Lin SF, et al. A tale of two fibrillations. Circulation. 2003;108:2298–2303

 This work was supported by a Beginning Grant-in-Aid from the Western Pennsylvania Affiliate of the American Heart Association to Dr. Choi and by National Institutes of Health Grants HL057929, HL70722, and HL69097 to Dr. Salama.

PII: S1547-5271(07)00370-0

doi: 10.1016/j.hrthm.2007.03.037

Heart Rhythm
Volume 4, Issue 8 , Pages 1057-1068 , August 2007

Article Tools

* Image Usage & Resolution