Virtual electrodes and deexcitation: New insights into fibrillation induction and defibrillation

Igor R. Efimov*, Richard A. Gray, Bradley J. Roth

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

146 Scopus citations


Previous models of fibrillation induction and defibrillation stressed the contribution of depolarization during the response of the heart to a shock. This article reviews recent evidence suggesting that comprehending the role of negative polarization (hyperpolarization) also is crucial for understanding the response to a shock. Negative polarization can 'deexcite' cardiac cells, creating regions of excitable tissue through which wavefronts can propagate. These wavefronts can result in new reentrant circuits, inducing fibrillation or causing defibrillation to fail. In addition, deexcitation can lead to rapid propagation through newly excitable regions, resulting in the elimination of excitable gaps soon after the shock and causing defibrillation to succeed.

Original languageEnglish (US)
Pages (from-to)339-353
Number of pages15
JournalJournal of cardiovascular electrophysiology
Issue number3
StatePublished - 2000


  • Defibrillation
  • Electric shock
  • Sudden cardiac death
  • Ventricular fibrillation
  • Ventricular tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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