Wavebreak Formation During Ventricular Fibrillation in the Isolated, Regionally Ischemic Pig Heart

ABSTRACT—Both fixed and dynamic heterogeneities were implicated in the mechanism of wavebreak (WB) generation during ventricular fibrillation (VF). However, their relative roles remain unclear. We hypothesized that during ischemic VF, the WBs are produced primarily because of a fixed heterogeneity;...

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Veröffentlicht in:Circulation research 2003-03, Vol.92 (5), p.546-553
Hauptverfasser: Zaitsev, Alexey V, Guha, Prabal K, Sarmast, Farzad, Kolli, Arun, Berenfeld, Omer, Pertsov, Arkady M, de Groot, Joris R, Coronel, Ruben, Jalife, José
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container_end_page 553
container_issue 5
container_start_page 546
container_title Circulation research
container_volume 92
creator Zaitsev, Alexey V
Guha, Prabal K
Sarmast, Farzad
Kolli, Arun
Berenfeld, Omer
Pertsov, Arkady M
de Groot, Joris R
Coronel, Ruben
Jalife, José
description ABSTRACT—Both fixed and dynamic heterogeneities were implicated in the mechanism of wavebreak (WB) generation during ventricular fibrillation (VF). However, their relative roles remain unclear. We hypothesized that during ischemic VF, the WBs are produced primarily because of a fixed heterogeneity; namely, the gradient of refractoriness across the ischemic border zone (BZ). Ischemia was induced in 15 isolated blood-perfused hearts by occluding the left anterior descending coronary artery. Simultaneous video imaging (≈32×32 mm) of Di-4-ANEPPS fluorescence in the ischemic zone (IZ), the BZ, and the nonischemic zone (NIZ) was performed. Dominant-frequency maps were constructed to assess gradients of refractoriness during VF. We used singularity points analysis to quantify the incidence of WBs per square centimeter per second. During preischemic VF, the distribution of WBs was relatively uniform. Ischemia caused an increase of WBs in the BZ (from 6.2±2.8 to 10.8±4.0) and a decrease of WBs in the IZ (from 5.8±2.8 to 2.8±1.4), without a significant change in NIZ (from 6.4±2.3 to 4.1±1.7). This finding is fully consistent with the dominant-frequency distribution during ischemic VFthe average dominant frequency was significantly slower in IZ than in NIZ (7.8±0.7 versus 10.1±1.0 Hz), suggesting a large gradient in refractory periods across the BZ. We concluded that acute regional ischemia plays a dual role in the maintenance of VF, decreasing the incidence of WB in the IZ while increasing it in the BZ. This suggests a predominant role of fixed heterogeneities in the formation of WB during VF in acute regional ischemia.
doi_str_mv 10.1161/01.RES.0000061917.23107.F7
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However, their relative roles remain unclear. We hypothesized that during ischemic VF, the WBs are produced primarily because of a fixed heterogeneity; namely, the gradient of refractoriness across the ischemic border zone (BZ). Ischemia was induced in 15 isolated blood-perfused hearts by occluding the left anterior descending coronary artery. Simultaneous video imaging (≈32×32 mm) of Di-4-ANEPPS fluorescence in the ischemic zone (IZ), the BZ, and the nonischemic zone (NIZ) was performed. Dominant-frequency maps were constructed to assess gradients of refractoriness during VF. We used singularity points analysis to quantify the incidence of WBs per square centimeter per second. During preischemic VF, the distribution of WBs was relatively uniform. Ischemia caused an increase of WBs in the BZ (from 6.2±2.8 to 10.8±4.0) and a decrease of WBs in the IZ (from 5.8±2.8 to 2.8±1.4), without a significant change in NIZ (from 6.4±2.3 to 4.1±1.7). 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Mar 21 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5712-e306067a9b1e8ffe431802028d9a13d95d6d077a4ddbf452aaa77943328563cd3</citedby><cites>FETCH-LOGICAL-c5712-e306067a9b1e8ffe431802028d9a13d95d6d077a4ddbf452aaa77943328563cd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,3691,27933,27934</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=14672565$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12600877$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zaitsev, Alexey V</creatorcontrib><creatorcontrib>Guha, Prabal K</creatorcontrib><creatorcontrib>Sarmast, Farzad</creatorcontrib><creatorcontrib>Kolli, Arun</creatorcontrib><creatorcontrib>Berenfeld, Omer</creatorcontrib><creatorcontrib>Pertsov, Arkady M</creatorcontrib><creatorcontrib>de Groot, Joris R</creatorcontrib><creatorcontrib>Coronel, Ruben</creatorcontrib><creatorcontrib>Jalife, José</creatorcontrib><title>Wavebreak Formation During Ventricular Fibrillation in the Isolated, Regionally Ischemic Pig Heart</title><title>Circulation research</title><addtitle>Circ Res</addtitle><description>ABSTRACT—Both fixed and dynamic heterogeneities were implicated in the mechanism of wavebreak (WB) generation during ventricular fibrillation (VF). However, their relative roles remain unclear. We hypothesized that during ischemic VF, the WBs are produced primarily because of a fixed heterogeneity; namely, the gradient of refractoriness across the ischemic border zone (BZ). Ischemia was induced in 15 isolated blood-perfused hearts by occluding the left anterior descending coronary artery. Simultaneous video imaging (≈32×32 mm) of Di-4-ANEPPS fluorescence in the ischemic zone (IZ), the BZ, and the nonischemic zone (NIZ) was performed. Dominant-frequency maps were constructed to assess gradients of refractoriness during VF. We used singularity points analysis to quantify the incidence of WBs per square centimeter per second. During preischemic VF, the distribution of WBs was relatively uniform. Ischemia caused an increase of WBs in the BZ (from 6.2±2.8 to 10.8±4.0) and a decrease of WBs in the IZ (from 5.8±2.8 to 2.8±1.4), without a significant change in NIZ (from 6.4±2.3 to 4.1±1.7). 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Vascular system</topic><topic>Female</topic><topic>Heart</topic><topic>Heart - physiopathology</topic><topic>Kinetics</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Myocardial Ischemia - physiopathology</topic><topic>Organ Culture Techniques</topic><topic>Swine</topic><topic>Ventricular Fibrillation - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zaitsev, Alexey V</creatorcontrib><creatorcontrib>Guha, Prabal K</creatorcontrib><creatorcontrib>Sarmast, Farzad</creatorcontrib><creatorcontrib>Kolli, Arun</creatorcontrib><creatorcontrib>Berenfeld, Omer</creatorcontrib><creatorcontrib>Pertsov, Arkady M</creatorcontrib><creatorcontrib>de Groot, Joris R</creatorcontrib><creatorcontrib>Coronel, Ruben</creatorcontrib><creatorcontrib>Jalife, José</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zaitsev, Alexey V</au><au>Guha, Prabal K</au><au>Sarmast, Farzad</au><au>Kolli, Arun</au><au>Berenfeld, Omer</au><au>Pertsov, Arkady M</au><au>de Groot, Joris R</au><au>Coronel, Ruben</au><au>Jalife, José</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Wavebreak Formation During Ventricular Fibrillation in the Isolated, Regionally Ischemic Pig Heart</atitle><jtitle>Circulation research</jtitle><addtitle>Circ Res</addtitle><date>2003-03-21</date><risdate>2003</risdate><volume>92</volume><issue>5</issue><spage>546</spage><epage>553</epage><pages>546-553</pages><issn>0009-7330</issn><eissn>1524-4571</eissn><coden>CIRUAL</coden><abstract>ABSTRACT—Both fixed and dynamic heterogeneities were implicated in the mechanism of wavebreak (WB) generation during ventricular fibrillation (VF). However, their relative roles remain unclear. We hypothesized that during ischemic VF, the WBs are produced primarily because of a fixed heterogeneity; namely, the gradient of refractoriness across the ischemic border zone (BZ). Ischemia was induced in 15 isolated blood-perfused hearts by occluding the left anterior descending coronary artery. Simultaneous video imaging (≈32×32 mm) of Di-4-ANEPPS fluorescence in the ischemic zone (IZ), the BZ, and the nonischemic zone (NIZ) was performed. Dominant-frequency maps were constructed to assess gradients of refractoriness during VF. We used singularity points analysis to quantify the incidence of WBs per square centimeter per second. During preischemic VF, the distribution of WBs was relatively uniform. Ischemia caused an increase of WBs in the BZ (from 6.2±2.8 to 10.8±4.0) and a decrease of WBs in the IZ (from 5.8±2.8 to 2.8±1.4), without a significant change in NIZ (from 6.4±2.3 to 4.1±1.7). This finding is fully consistent with the dominant-frequency distribution during ischemic VFthe average dominant frequency was significantly slower in IZ than in NIZ (7.8±0.7 versus 10.1±1.0 Hz), suggesting a large gradient in refractory periods across the BZ. We concluded that acute regional ischemia plays a dual role in the maintenance of VF, decreasing the incidence of WB in the IZ while increasing it in the BZ. This suggests a predominant role of fixed heterogeneities in the formation of WB during VF in acute regional ischemia.</abstract><cop>Hagerstown, MD</cop><pub>American Heart Association, Inc</pub><pmid>12600877</pmid><doi>10.1161/01.RES.0000061917.23107.F7</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete
subjects Acute Disease
Animals
Biological and medical sciences
Body Surface Potential Mapping
Cardiac dysrhythmias
Cardiology. Vascular system
Female
Heart
Heart - physiopathology
Kinetics
Male
Medical sciences
Myocardial Ischemia - physiopathology
Organ Culture Techniques
Swine
Ventricular Fibrillation - physiopathology
title Wavebreak Formation During Ventricular Fibrillation in the Isolated, Regionally Ischemic Pig Heart
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