Ventricular fibrillation: one spiral or many?

Evans, Steven J.; Hastings, Harold M.; Nangia, Sushma; Chin, Ji-Hyun; Smolow, M.; Nwasokwa, Obi N.; Garfinkel, Alan

doi:10.1098/rspb.1998.0554

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…However, other work has questioned the chaotic fibrillation hypothesis (45,46). The current prevailing theory (47), supported by a range of mathematical (48)(49)(50)(51)(52)(53)(54)(55)(56), in vitro (57)(58)(59), and in vivo (57,(60)(61)(62)(63)(64)(65)(66)(67)(68)(69)(70) studies, is that fibrillation is a complex nonlinear combination of stochastic and deterministic components, such as scroll waves of electrical activity meandering within the ventricular wall. Given this body of evidence, it is apparent that fibrillation is characterized by high-dimensional nonstationary spatiotemporal dynamics that are too complex for current nonlinear-dynamical control techniques.…”

Section: Discussionmentioning

confidence: 99%

Nonlinear-dynamical arrhythmia control in humans

Christini

Steín²,

Markowitz³

et al. 2001

Proc. Natl. Acad. Sci. U.S.A.

114

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Nonlinear-dynamical control techniques, also known as chaos control, have been used with great success to control a wide range of physical systems. Such techniques have been used to control the behavior of in vitro excitable biological tissue, suggesting their potential for clinical utility. However, the feasibility of using such techniques to control physiological processes has not been demonstrated in humans. Here we show that nonlinear-dynamical control can modulate human cardiac electrophysiological dynamics by rapidly stabilizing an unstable target rhythm. Specifically, in 52͞54 control attempts in five patients, we successfully terminated pacing-induced period-2 atrioventricular-nodal conduction alternans by stabilizing the underlying unstable steady-state conduction. This proof-of-concept demonstration shows that nonlinear-dynamical control techniques are clinically feasible and provides a foundation for developing such techniques for more complex forms of clinical arrhythmia.I ncreasingly, it is recognized that many cardiac arrhythmias can be characterized on the basis of the physical principles of nonlinear dynamics (1, 2). A nonlinear-dynamical system is one that changes with time and cannot be broken down into a linear sum of its individual components. For certain nonlinear systems, known as chaotic systems, behavior is aperiodic and long-term prediction is impossible, even though the dynamics are entirely deterministic (i.e., the dynamics of the system are completely determined from known inputs and the previous state of the system, with no influence from random inputs). Importantly, such determinism actually can be exploited to control the dynamics of a chaotic system. To this end, a variety of nonlineardynamical control techniques, also known as chaos control, ‡ have been developed (3, 4) and applied successfully to a wide range of physical systems (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Such techniques are modelindependent, i.e., they require no a priori knowledge of the underlying equations of a system and are therefore appropriate for systems that are essentially ''black boxes.''The success of nonlinear-dynamical control techniques in stabilizing physical systems, together with the facts that many physiological systems are nonlinear (e.g., the cardiac conduction system, because of its numerous complex nonlinear component interactions) and lack the detailed analytical system models required for model-based control techniques, have fostered widespread interest in applying these model-independent techniques to biological dynamical systems (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). In a pioneering application, Garfinkel et al. (15) stabilized drug-induced irregular cardiac rhythms by means of dynamically timed electrical stimulation in an in vitro rabbit ventricular-tissue preparation. That work was an important demonstration that the physical principles of nonlinear-dynamical control could be extended into the realm of cardiac dynamics. Although extension of that work to the control of fibrill...

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Section: Discussionmentioning

confidence: 99%

Nonlinear-dynamical arrhythmia control in humans

Christini

Steín²,

Markowitz³

et al. 2001

Proc. Natl. Acad. Sci. U.S.A.

114

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“…This possibility is supported by results of Evans and co-workers. 44 Another possibility is that the variation results from the ͑slow͒ variation of the parameters controlling the dynamics of the heart. Consequently the position of the attractor in phase space varies and its points are not located in the same region for a time that is sufficiently long to resolve the fine scales.…”

Section: Discussionmentioning

confidence: 99%

The correlation dimension of rat hearts in an experimentally controlled environment

Dori

Fishman

Ben‐Haim

2000

Chaos: An Interdisciplinary Journal of Nonlinear Science

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The electric response of several isolated rat hearts in a controlled environment was studied experimentally. The correlation dimension D(2) was estimated and was found to be between 4 and 6.5 when the response was nearly periodic. The variation of D(2) with the concentration of calcium was studied and a general trend of its increase with increasing concentration was found. Two types of ventricular fibrillation (VF) were observed, one that corresponds to a stochastic signal where D(2) is unbounded and the other to a low dimensional dynamical system with 3.5

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“…In recent years, multiple spiral patterns in a cardiac tissue has been paid more and more attention for its important biological function and physiological significance [5][6][7][8][9][10]. Recently, a new type of multispiral waves named as to multi-arm spirals have been found in two-dimensional cardiac substrate [6].…”

Section: ι Introductionmentioning

confidence: 99%

Multiple spiral patterns in a cardiac tissue

Bai

2009

SPIE Proceedings

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Ventricular fibrillation (VF) is the major cause of sudden cardiac death, the leading cause of death in the industrialized world. However, the mechanisms for its onset are still not well understood. Recent experiments indicate that VF is induced by transitions of cardiac electric propagationg waves from a single spiral wave to multiple waves. To further understand the underlying mechanism of VF, we investigated the interaction between two waves in a two-dimensional excitable media. Three types of multiple spirals including multi-arm spirals have been found depending on the rotation direction and the distance among spiral waves.

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Ventricular fibrillation: one spiral or many?

Cited by 6 publications

References 19 publications

Nonlinear-dynamical arrhythmia control in humans

Nonlinear-dynamical arrhythmia control in humans

The correlation dimension of rat hearts in an experimentally controlled environment

Multiple spiral patterns in a cardiac tissue

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