Optical mapping of successful and failed defibrillation

This chapter summarizes the current understanding of fibrillation and defibrillation mechanisms, and also explores one of the leading hypotheses of defibrillation, the virtual electrode polarization (VEP) hypothesis. The VEP hypothesis of defibrillation presents the most comprehensive explanation of defibrillation. It is based on solid experimental evidence and theoretical foundation. The chapter explores the VEP mechanism in more detail, especially in the context of successful and failed defibrillation mechanisms using optical mapping technology. The virtual electrode hypothesis of defibrillation, along with optical mapping techniques has made great strides toward explaining many experimentally and clinically observed phenomena, with implications for safe and efficient defibrillation. However, clinical advances are still to be gained from this knowledge. The authors believe further improvement of the VEP hypothesis of defibrillation may result in development of damage- and pain-free, effective and safe therapy that could realistically be translated to humans.