Mechanisms of Cardiac Fibrillation

Gray, Richard A.; Jalife, José; Panfilov, Alexander V.; Baxter, William T.; Cabo, Cándido; Davidenko, Jorge M.; Pertsov, Arkady M.

doi:10.1126/science.270.5239.1222

Cited by 409 publications

(245 citation statements)

References 13 publications

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“…According to the latter, the shift of the origin of the waves towards and away from the recording point accelerates and slows the activation rates, respectively. 13 The data on transmembrane voltage presented in figure OS4 also confirm that fractionation may be a result of variability in local activity, and not only the result of core activity detection by farfield probing with the unipolar electrode, as might be suspected for the fractionated signals presented in figure 4.…”

Section: Meandering As a Source Of Irregularitysupporting

confidence: 61%

Rotor meandering contributes to irregularity in electrograms during atrial fibrillation

Zlochiver¹,

Yamazaki²,

Kalifa³

et al. 2008

Heart Rhythm

153

122

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Radiofrequency ablation therapy of atrial fibrillation (AF) recently incorporated the analysis of dominant frequency (DF) and/or electrogram fractionation for guidance. However, the relationships between DF, fractionation and spatio-temporal characteristics of the AF source remain unclear. We hypothesize that meandering reentrant AF source contributes to the wave fractionation and is reflected in the power spectrum of local electrograms elsewhere in the rotor's surroundings.Methods-Meandering rotors as AF sources were simulated in 2D models of human atrial tissue and recorded in isolated sheep hearts. Non-dominant elements of the signals were differentiated from the dominant elements using singular value decomposition, whereby the purely periodic constituent (PC) relating to the rotor's DF was eliminated rendering a residual constituent (RC) that consisted of all other activity.Results-Spectral analysis of the decomposed constituents revealed peaks corresponding to the meandering frequency of the rotor tip, the magnitudes of which were proportional to the size of, and the distance to the rotor core. Similar analyses on epicardial optical signals and electrograms from isolated sheep hearts, as well as human complex fractionated atrial electrograms demonstrated applicability of the approach.Conclusion-Increased meandering of the rotor driving AF reduces activation periodicity and increases fractionation. The spectral manifestation of the rotor activity beyond the meandering region makes it possible to characterize AF source stability, as well as DF in humans using electrode mapping.

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Section: Meandering As a Source Of Irregularitysupporting

confidence: 61%

Rotor meandering contributes to irregularity in electrograms during atrial fibrillation

Zlochiver¹,

Yamazaki²,

Kalifa³

et al. 2008

Heart Rhythm

153

122

View full text Add to dashboard Cite

show abstract

“…The third and fourth oscillations in the quasiperiodic scenario are the period and amplitude modulations that immediately precede and precipitate the transition to chaos. They correspond to the onset of meander of the primary spiral wave, which is mathematically a transition to quasiperiodicity, and has been shown to cause quasiperiodic modulations of period and amplitude in heart tissue (29,50,51). Theoretical studies of cardiac wave propagation in one-dimensional rings of tissue (52) have attributed the onset of quasiperiodicity to APD restitution and the restitution of (dV/dt) max , and similar quasiperiodic modulations have been observed in rings of cardiac tissue (53).…”

Section: Discussionmentioning

confidence: 74%

“…5. Hypermeander of a single spiral wave has recently been shown in the isolated rabbit heart to produce the electrocardiographic pattern of fibrillation (29). Subsequent breakup of a single meandering spiral wave into multiple spiral waves may also occur in sustained fibrillation.…”

Section: Resultsmentioning

confidence: 99%

Quasiperiodicity and chaos in cardiac fibrillation.

et al. 1997

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In cardiac fibrillation, disorganized waves of electrical activity meander through the heart, and coherent contractile function is lost. We studied fibrillation in three stationary forms: in human chronic atrial fibrillation, in a stabilized form of canine ventricular fibrillation, and in fibrillationlike activity in thin sheets of canine and human ventricular tissue in vitro. We also created a computer model of fibrillation. In all four studies, evidence indicated that fibrillation arose through a quasiperiodic stage of period and amplitude modulation, thus exemplifying the "quasiperiodic transition to chaos" first suggested by Ruelle and Takens. This suggests that fibrillation is a form of spatio-temporal chaos, a finding that implies new therapeutic approaches. ( J. Clin. Invest. 1997. 99:305-314.)

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“…Fibrillation is generally thought to be a highly disorganized pattern of electrical activation of the heart consisting of reentrant "spirals" that are continually created and destroyed (Gray et al 1995;Panfilov 1998;Panfilov 1999;Choi et al 2002). An alternate hypothesis (Jalife and Berenfeld 2004) is that fibrillation is organized and sustained by a "mother rotor" with emanating waves of excitation that break apart into the complicated wave pattern typical of fibrillation.…”

Section: Introductionmentioning

confidence: 99%

The topology of defibrillation

Keener

2004

Journal of Theoretical Biology

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We describe how Art Winfree's ideas about phase singularities can be used to understand the response of cardiac tissue with a random preexisting pattern of reentrant waves (fibrillation) to a large brief current stimulus. This discussion is organized around spatial dimension, beginning with a discussion of reentry on a periodic ring, followed by reentry in a two dimensional planar domain (spiral waves), and ending with consideration of three dimensional reentrant patterns (scroll waves). In all cases we show how reentrant activity is changed by the application of a shock, describing conditions under which defibrillation is successful or not.Using topological arguments we draw the general conclusion that with a generic placement of stimulating electrodes, large scale virtual electrodes do not give an adequate explanation for the mechanism of defibrillation.

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Mechanisms of Cardiac Fibrillation

Abstract: MItL to the following relationship: 11 3. 5. Dibbs et a)., AIDS Res. Hum. Retrovir. 10, 607 and 2BD1 A135533 02, DAMD grant 1 7 94-J-4431 (1994) Fig. 1 A, the frequency of lence in 3Ds only, then we will find no breakrotation of the rotor (f s = 7.5 Hz) was calculated

Cited by 409 publications

References 13 publications

Rotor meandering contributes to irregularity in electrograms during atrial fibrillation

Rotor meandering contributes to irregularity in electrograms during atrial fibrillation

Quasiperiodicity and chaos in cardiac fibrillation.

The topology of defibrillation

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