Imaging of Ventricular Fibrillation and Defibrillation: The Virtual Electrode Hypothesis

Bastiaan J. Boukens, Sarah R. Gutbrod, Igor R. Efimov

Research output: Contribution to journalReview articlepeer-review

12 Scopus citations

Abstract

Ventricular fibrillation is the major underlying cause of sudden cardiac death. Understanding the complex activation patterns that give rise to ventricular fibrillation requires high resolution mapping of localized activation. The use of multi-electrode mapping unraveled re-entrant activation patterns that underlie ventricular fibrillation. However, optical mapping contributed critically to understanding the mechanism of defibrillation, where multi-electrode recordings could not measure activation patterns during and immediately after a shock. In addition, optical mapping visualizes the virtual electrodes that are generated during stimulation and defibrillation pulses, which contributed to the formulation of the virtual electrode hypothesis. The generation of virtual electrode induced phase singularities during defibrillation is arrhythmogenic and may lead to the induction of fibrillation subsequent to defibrillation. Defibrillating with low energy may circumvent this problem. Therefore, the current challenge is to use the knowledge provided by optical mapping to develop a low energy approach of defibrillation, which may lead to more successful defibrillation.

Original languageEnglish (US)
Pages (from-to)343-365
Number of pages23
JournalAdvances in experimental medicine and biology
Volume859
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology

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