Computerized mapping of fibrillation in normal ventricular myocardium

Peng-Sheng Chen, Alan Garfinkel, James N. Weiss, Hrayr S. Karagueuzian

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

It is well known that the ability to fibrillate is intrinsic to a normal ventricle that exceeds a critical mass. The questions we address are how is ventricular fibrillation (VF) initiated and perpetuated in normal myocardium, and why is VF not seen more often in the general population if all ventricles have the ability to fibrillate. To study the mechanisms of VF, we used computerized mapping techniques with up to 512 channels of simultaneous multisite recordings for data acquisition. The data were then processed for dynamic display of the activation patterns and for mathematical analyses of the activation intervals. The results show that in normal ventricles, VF can be initiated by a single strong premature stimulus given during the vulnerable period of the cardiac cycle. The initial activations form a figure-eight pattern. Afterward, VF will perpetuate itself without any outside help. The self-perpetuation itself is due to at least two factors. One is that single wave fronts spontaneously break up into two or more wavelets. The second is that when two wavelets intersect perpendicular to each other, the second wavelet is broken by the residual refractoriness left over from the first wavelet. Mathematical analyses of the patterns of activation during VF revealed that VF is a form of chaos, and that transition from ventricular tachycardia (VT) to VF occurs via the quasiperiodic route. In separate experiments, we found that we can convert VF to VT by tissue size reduction. The physiological mechanism associated with the latter transition appears to be the reduction of the number of reentrant wave fronts and wandering wavelets. Based on these findings, we propose that the reentrant wave fronts and the wandering wavelets serve as the physiological equivalent of coupled oscillators. A minimal number of oscillators is needed for VF to perpetuate itself, and to generate chaotic dynamics; hence a critical mass is required to perpetuate VF. We conclude that VF in normal myocardium is a form of reentrant cardiac arrhythmia. A strong electrical stimulus initiates single or dual reentrant wave fronts that break up into multiple wavelets. Sometimes short-lived reentry is also generated during the course of VF. These organized reentrant and broken wavelets serve as coupled oscillators that perpetuate VF and maintain chaos. Although the ability to support these oscillators exists in a normal ventricle, the triggers required to generate them are nonexistent in the normal heart. Therefore, VF and sudden death do not happen to most people with normal ventricular myocardium.

Original languageEnglish (US)
Pages (from-to)127-136
Number of pages10
JournalChaos
Volume8
Issue number1
StatePublished - Mar 1998
Externally publishedYes

Fingerprint

fibrillation
Ventricular Fibrillation
myocardium
Myocardium
Chemical activation
Chaos theory
Wavelets
Reentry
wave fronts
Wave Front
Activation
Data acquisition
tachycardia
oscillators
activation
Display devices
Ventricular Tachycardia
critical mass
Tissue
Breakup

ASJC Scopus subject areas

  • Applied Mathematics
  • Mathematical Physics
  • Physics and Astronomy(all)
  • Statistical and Nonlinear Physics

Cite this

Chen, P-S., Garfinkel, A., Weiss, J. N., & Karagueuzian, H. S. (1998). Computerized mapping of fibrillation in normal ventricular myocardium. Chaos, 8(1), 127-136.

Computerized mapping of fibrillation in normal ventricular myocardium. / Chen, Peng-Sheng; Garfinkel, Alan; Weiss, James N.; Karagueuzian, Hrayr S.

In: Chaos, Vol. 8, No. 1, 03.1998, p. 127-136.

Research output: Contribution to journalArticle

Chen, P-S, Garfinkel, A, Weiss, JN & Karagueuzian, HS 1998, 'Computerized mapping of fibrillation in normal ventricular myocardium', Chaos, vol. 8, no. 1, pp. 127-136.
Chen P-S, Garfinkel A, Weiss JN, Karagueuzian HS. Computerized mapping of fibrillation in normal ventricular myocardium. Chaos. 1998 Mar;8(1):127-136.
Chen, Peng-Sheng ; Garfinkel, Alan ; Weiss, James N. ; Karagueuzian, Hrayr S. / Computerized mapping of fibrillation in normal ventricular myocardium. In: Chaos. 1998 ; Vol. 8, No. 1. pp. 127-136.
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