Obstacle-induced transition from ventricular fibrillation to tachycardia in isolated swine right ventricles

Insights into the transition dynamics and implications for the critical mass

Miguel Valderrábano, Young Hoon Kim, Masaaki Yashima, Tsu Juey Wu, Hrayr S. Karagueuzian, Peng Sheng Chen

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Objectives: The study was done to test the hypothesis that an artificial anatomical obstacle prevents the maintenance of ventricular fibrillation (VF) by stabilizing reentrant wavefronts (RWF) and increases the critical mass (CM) of myocardium required to sustain VF. Background: Artificial obstacles can anchor RWF in simulated models of VF. Whether an artificial obstacle affects multiple-wavelet VF in real tissue is unclear. Methods: The endocardial surfaces of seven isolated, perfused swine right ventricles were mapped using a plaque of 477 bipolar electrodes with 1.6-mm resolution. An 8-mm hole was punched in the tissue. The CM was reached by tissue mass reductions, at which VF converted to periodic activity (ventricular tachycardia, VT). Results: After the creation of the obstacle, the VF cycle length increased from 71.6 ± 18.4 ms to 87.5 ± 13.0 ms (p < 0.05). The obstacle, together with the papillary muscle, facilitated the transition from VF to VT by serving as attachment sites for the RWF. When one RWF attaches to the obstacle and another attaches to the papillary muscle, it may result in stable VT with figure-eight patterns. The CM for VF in the presence of an 8-mm hole (28.7 ± 3.8 g) was higher than in the control group (swine right ventricles without holes, 24.0 ± 3.4 g, p < 0.05). Conclusions: An artificial anatomical obstacle induces slowing and regularization of VF, impairs the persistence of VF as judged by an increase of the CM, and can convert VF to VT by serving as an attachment site to reentrant excitation. (C) 2000 by the American College of Cardiology.

Original languageEnglish
Pages (from-to)2000-2008
Number of pages9
JournalJournal of the American College of Cardiology
Volume36
Issue number6
DOIs
Publication statusPublished - 2000 Nov 15
Externally publishedYes

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Ventricular Fibrillation
Tachycardia
Heart Ventricles
Swine
Ventricular Tachycardia
Papillary Muscles
Myocardium
Electrodes
Maintenance
Control Groups

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Obstacle-induced transition from ventricular fibrillation to tachycardia in isolated swine right ventricles : Insights into the transition dynamics and implications for the critical mass. / Valderrábano, Miguel; Kim, Young Hoon; Yashima, Masaaki; Wu, Tsu Juey; Karagueuzian, Hrayr S.; Chen, Peng Sheng.

In: Journal of the American College of Cardiology, Vol. 36, No. 6, 15.11.2000, p. 2000-2008.

Research output: Contribution to journalArticle

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