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Spiral wave breakup: Optical mapping in an explanted human heart shows the transition from ventricular tachycardia to ventricular fibrillation and self-termination

      Since the first demonstration of ventricular fibrillation induction by electrical stimulation in 1850 by Hoffa and Ludwig,
      • Hoffa M.
      • Ludwig C.
      Einige neue Versuche uber Herzbewegung.
      many mechanisms
      • Jalife J.
      Ventricular fibrillation: mechanisms of initiation and maintenance.
      ,
      • Fenton F.H.
      • Cherry E.M.
      • Hastings H.M.
      • Evans S.J.
      Multiple mechanisms of spiral wave breakup in a model of cardiac electrical activity.
      have been identified that initiate the complex dynamics of fibrillation. We report a high-resolution visualization of a spiral wave transitioning into multiple waves in human ventricles by using optical mapping (voltage and calcium) from the posterior epicardial surface (∼7 × 7 cm2) of an explanted heart from a 38-year-old female transplant recipient.

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      References

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        • Ludwig C.
        Einige neue Versuche uber Herzbewegung.
        Zeitschr Rat Med. 1850; 9: 107-144
        • Jalife J.
        Ventricular fibrillation: mechanisms of initiation and maintenance.
        Annu Rev Physiol. 2000; 62: 25-50
        • Fenton F.H.
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        Multiple mechanisms of spiral wave breakup in a model of cardiac electrical activity.
        Chaos. 2002; 12: 852-892
        • Fenton F.
        • Karma A.
        Vortex dynamics in three-dimensional continuous myocardium with fiber rotation: filament instability and fibrillation.
        Chaos. 1998; 8: 20-47
        • Wu T.J.
        • Yashima M.
        • Doshi R.
        • et al.
        Relation between cellular repolarization characteristics and critical mass for human ventricular fibrillation.
        J Cardiovasc Electrophysiol. 1999; 10: 1077-1086