Panoramic optical mapping reveals continuous epicardial reentry during ventricular fibrillation in the isolated swine heart

Academic Article

Abstract

  • During ventricular fibrillation (VF), activation waves are fragmented and the heart cannot contract synchronously. It has been proposed that VF waves emanate from stable sources ("mother rotors"). Previously, we used new optical mapping technology to image VF wavefronts from nearly the entire epicardial surface of six isolated swine hearts. We found that VF was not driven by epicardial rotors, but could not exclude the presence of stable rotors hidden within the ventricular walls. Here, we use graph theoretic analysis to show that, in all 17 VF episodes we analyzed, it was always possible to trace sequences of wavefronts through series of fragmentation and collision events from the beginning to the end of the episode. The set of wavefronts that were so related (the dominant component) consisted of 92% ± 1% of epicardial wavefronts. Because each such wavefront sequence constitutes a continuous activation front, this finding shows that complete reentrant pathways were always present on the epicardial surface and therefore, that wavefront infusion from nonepicardial sources was not strictly necessary for VF maintenance. These data suggest that VF in this model is not driven by localized sources; thus, new anti-VF treatments designed to target such sources may be less effective than global interventions. © 2007 by the Biophysical Society.
  • Authors

    Digital Object Identifier (doi)

    Author List

  • Rogers JM; Walcott GP; Gladden JD; Melnick SB; Kay MW
  • Start Page

  • 1090
  • End Page

  • 1095
  • Volume

  • 92
  • Issue

  • 3