Advertisement

Direct observation of a stable spiral wave reentry in ventricles of a whole human heart using optical mapping for voltage and calcium

      From the studies of Gordon Moe in the 1960s, functional reentry has been investigated as a mechanism for tachycardia and fibrillation; however, it was not until 1990 that optical mapping (OM) experiments using sheep hearts verified the existence of reentrant spiral waves.
      • Davidenko J.M.
      • Kent P.F.
      • Chialvo D.R.
      • et al.
      Sustained vortex-like waves in normal isolated ventricular muscle.
      Eventually, it was shown that electromechanical 3-dimensional vortex filaments drive cardiac fibrillation.
      • Christoph J.
      • Chebbok M.
      • Richter C.
      • et al.
      Electromechanical vortex filaments during cardiac fibrillation.
      To date, only multiple complex and short-lived reentrant waves have been recorded using OM on human ventricles.
      • Nanthakumar K.
      • Jalife J.
      • Massé S.
      • et al.
      Optical mapping of Langendorff-perfused human hearts: establishing a model for the study of ventricular fibrillation in humans.
      The presence of single spiral waves in human ventricles has only been demonstrated using low-resolution intracardiac electrocardiograms (ECGs).
      • Krummen D.E.
      • Hayase J.
      • Morris D.J.
      • et al.
      Rotor stability separates sustained ventricular fibrillation from self-terminating episodes in humans.
      We report the first high-resolution visualization of a stable spiral wave in human ventricles using OM (voltage and calcium) (Figure 1A ) of the posterior epicardial surface (∼7 × 7 cm2) of an explanted heart from a 38-year-old female transplant recipient, who presented with cardiogenic shock secondary to viral cardiomyopathy.
      Figure thumbnail gr1
      Figure 1A: Movie frame showing an instant in time of the clockwise functional reentrant waves for voltage and calcium. Below are the voltage and calcium signals in time from one pixel in the center of the tissue. B: Image of the heart identifying the RV and LV; lower image shows contour lines during one rotation of the voltage signal. LV = left ventricle; RV = right ventricle.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Heart Rhythm
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Davidenko J.M.
        • Kent P.F.
        • Chialvo D.R.
        • et al.
        Sustained vortex-like waves in normal isolated ventricular muscle.
        Proc Natl Acad Sci U S A. 1990; 87: 8785-8789
        • Christoph J.
        • Chebbok M.
        • Richter C.
        • et al.
        Electromechanical vortex filaments during cardiac fibrillation.
        Nature. 2018; 555: 667-672
        • Nanthakumar K.
        • Jalife J.
        • Massé S.
        • et al.
        Optical mapping of Langendorff-perfused human hearts: establishing a model for the study of ventricular fibrillation in humans.
        Am J Physiol Heart Circ Physiol. 2007; 293: H875-H880
        • Krummen D.E.
        • Hayase J.
        • Morris D.J.
        • et al.
        Rotor stability separates sustained ventricular fibrillation from self-terminating episodes in humans.
        J Am Coll Cardiol. 2014; 63: 2712-2721
        • Uzelac I.
        • Crowley C.J.
        • Iravanian S.
        • et al.
        Methodology for cross-talk elimination in simultaneous voltage and calcium optical mapping measurements with semasbestic wavelengths.
        Front Physiol. 2022; 13812968