Ventricular Defibrillation Combining DC Electrical Field and Electrical Pacing

An Optical Mapping Study

Sai Shruthi Musunuri, Liang Tang, Boyoung Joung, Edward J. Berbari, Shien-Fong Lin

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Citation (Scopus)

Abstract

Although high voltage direct current (DC) shock is a standard technique to terminate ventricular fibrillation (VF), it can cause severe pain and tissue damage. The exact effect of the DC electric field, which can depolarize the heart during VF is still unknown. We hypothesized that low-energy DC field in combination with pacing (pacing+DC) could terminate VF by affecting the ventricular propagation pattern. In six Langendorff-perfused isolated rabbit hearts with the ablated sinoatrial (SA) node, the DC field was delivered to the left ventricle (cathode) and right ventricle (anode). We designed a timed protocol using LabVIEW programming that delivers pacing, DC and pacing+DC stimuli for two seconds time intervals each. The pacing pulse (with varying pacing cycle length: 300ms-30ms) was delivered to the apex. Transmembrane voltage was recorded with optical mapping technique for 16 seconds at a sampling rate of 2ms/frame. We crushed the sinoatrial node to reduce the heart rate. The baseline activation appeared to have endocardial origins with a mean escape ventricular rate of 60 ± 5bpm at baseline. The DC field (30mA-60mA) alone increased the mean heart rate to 120±5bpm. Although DC alone terminated VF in a few cases, the rate of termination was very low (6.2%). However, when pacing+DC was applied, it was possible to terminate VF in 34 of 130 episodes in six rabbits. The rate of successful defibrillation of VF with pacing+DC was significantly higher than that with DC alone (20% vs 6.2%, p<0.01). Pacing alone never terminated the VF. In conclusion, DC field may affect the conduction velocity in normal condition. Pacing+DC intervention could lead to regularization of VF propagation and eventually to termination. Further improvement of this approach may offer a higher success rate of defibrillation with lower energy requirements.

Original languageEnglish
Title of host publicationProgress in Biomedical Optics and Imaging - Proceedings of SPIE
Volume7182
DOIs
StatePublished - 2009
EventImaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues VII - San Jose, CA, United States
Duration: Jan 26 2009Jan 28 2009

Other

OtherImaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues VII
CountryUnited States
CitySan Jose, CA
Period1/26/091/28/09

Fingerprint

Defibrillation
fibrillation
Ventricular Fibrillation
direct current
Electric potential
Terminate
Anodes
Cathodes
Chemical activation
Electric fields
heart rate
Tissue
Sampling
rabbits
Heart Rate
Rabbit
Termination
Baseline
Voltage
Propagation

Keywords

  • DC electric field
  • Defibrillation
  • Electrical pacing
  • Optical mapping
  • Pacing+DC
  • VF

ASJC Scopus subject areas

  • Applied Mathematics
  • Computer Science Applications
  • Electrical and Electronic Engineering
  • Electronic, Optical and Magnetic Materials
  • Condensed Matter Physics

Cite this

Musunuri, S. S., Tang, L., Joung, B., Berbari, E. J., & Lin, S-F. (2009). Ventricular Defibrillation Combining DC Electrical Field and Electrical Pacing: An Optical Mapping Study. In Progress in Biomedical Optics and Imaging - Proceedings of SPIE (Vol. 7182). [718214] https://doi.org/10.1117/12.808274

Ventricular Defibrillation Combining DC Electrical Field and Electrical Pacing : An Optical Mapping Study. / Musunuri, Sai Shruthi; Tang, Liang; Joung, Boyoung; Berbari, Edward J.; Lin, Shien-Fong.

Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 7182 2009. 718214.

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Musunuri, SS, Tang, L, Joung, B, Berbari, EJ & Lin, S-F 2009, Ventricular Defibrillation Combining DC Electrical Field and Electrical Pacing: An Optical Mapping Study. in Progress in Biomedical Optics and Imaging - Proceedings of SPIE. vol. 7182, 718214, Imaging, Manipulation, and Analysis of Biomolecules, Cells, and Tissues VII, San Jose, CA, United States, 1/26/09. https://doi.org/10.1117/12.808274
Musunuri SS, Tang L, Joung B, Berbari EJ, Lin S-F. Ventricular Defibrillation Combining DC Electrical Field and Electrical Pacing: An Optical Mapping Study. In Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 7182. 2009. 718214 https://doi.org/10.1117/12.808274
Musunuri, Sai Shruthi ; Tang, Liang ; Joung, Boyoung ; Berbari, Edward J. ; Lin, Shien-Fong. / Ventricular Defibrillation Combining DC Electrical Field and Electrical Pacing : An Optical Mapping Study. Progress in Biomedical Optics and Imaging - Proceedings of SPIE. Vol. 7182 2009.
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abstract = "Although high voltage direct current (DC) shock is a standard technique to terminate ventricular fibrillation (VF), it can cause severe pain and tissue damage. The exact effect of the DC electric field, which can depolarize the heart during VF is still unknown. We hypothesized that low-energy DC field in combination with pacing (pacing+DC) could terminate VF by affecting the ventricular propagation pattern. In six Langendorff-perfused isolated rabbit hearts with the ablated sinoatrial (SA) node, the DC field was delivered to the left ventricle (cathode) and right ventricle (anode). We designed a timed protocol using LabVIEW programming that delivers pacing, DC and pacing+DC stimuli for two seconds time intervals each. The pacing pulse (with varying pacing cycle length: 300ms-30ms) was delivered to the apex. Transmembrane voltage was recorded with optical mapping technique for 16 seconds at a sampling rate of 2ms/frame. We crushed the sinoatrial node to reduce the heart rate. The baseline activation appeared to have endocardial origins with a mean escape ventricular rate of 60 ± 5bpm at baseline. The DC field (30mA-60mA) alone increased the mean heart rate to 120±5bpm. Although DC alone terminated VF in a few cases, the rate of termination was very low (6.2{\%}). However, when pacing+DC was applied, it was possible to terminate VF in 34 of 130 episodes in six rabbits. The rate of successful defibrillation of VF with pacing+DC was significantly higher than that with DC alone (20{\%} vs 6.2{\%}, p<0.01). Pacing alone never terminated the VF. In conclusion, DC field may affect the conduction velocity in normal condition. Pacing+DC intervention could lead to regularization of VF propagation and eventually to termination. Further improvement of this approach may offer a higher success rate of defibrillation with lower energy requirements.",
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