Organization of ventricular fibrillation in the human heart: experiments and models
Ten Tusscher, Kirsten H.W.J. (Author), Mourad, Azzam (Author), Nash, Martyn (Author), Clayton, Richard H. (Author), Bradley, Chris P. (Author), Paterson, David J. (Author), Hren, Rok (Author), Hayward, Martin (Author), Panfilov, Alexander V. (Author), Taggart, Peter (Author)

URLURL - Presentation file, Visit http://dx.doi.org/10.1113/expphysiol.2008.044065 This link opens in a new window

Sudden cardiac death is a major health problem in the industrialized world. The lethal event is typically ventricular fibrillation (VF), during which the co-ordinated regular contraction of the heart is overthrown by a state of mechanical and electrical anarchy. Understanding the excitation patterns that sustain VF is important in order to identify potential therapeutic targets. In this paper, we studied the organization of human VF by combining clinical recordings of electrical excitation patterns on the epicardial surface during in vivo human VF with simulations of VF in an anatomically and electrophysiologically detailed computational model of the human ventricles. We find both in the computational studies and in the clinical recordings that epicardial surface excitation patterns during VF contain around six rotors. Based on results from the simulated three-dimensional excitation patterns during VF, which show that the total number of electrical sources is ▫$1.4 \pm 0.12$▫ times greater than the number of epicardial rotors, we estimate that the total number of sources present during clinically recorded VF is ▫$9.0 \pm 2.6$▫. This number is approximately fivefold fewer compared with that observed during VF in dog and pig hearts, which are of comparable size to human hearts. We explain this difference by considering differences in action potential duration dynamics across these species. The simpler spatial organization of human VF has important implications for treatment and prevention of this dangerous arrhythmia. Moreover, our findings underline the need for integrated research, in which human-based clinical and computational studies complement animal research.

Keywords:electrophysiology, action potential duration-restitution-heterogeneity, reentrant arrhythmias, ventricular fibrillation, porcine left-ventricle, action-potential duration, isolated rabbit heart, restitution properties, swine ventricles, cardiac tissue, ischemia
Work type:Not categorized (r6)
Tipology:1.01 - Original Scientific Article
Organization:FMF - Faculty of Mathematics and Physics
Number of pages:str. 553-562
Numbering:Vol. 94, no. 5
ISSN on article:0958-0670
COBISS.SI-ID:15250009 Link is opened in a new window
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Record is a part of a journal

Title:Experimental physiology
Shortened title:Exp. physiol.
Publisher:Cambridge University Press
COBISS.SI-ID:512200473 This link opens in a new window

Secondary language

Keywords:elektrofiziologija, celice človeškega ventrikla, aritmija, računalniška simulacija

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