© 1999 American Heart Association, Inc.
Original Contribution |
Reentry and Fibrillation in the Mouse Heart
A Challenge to the Critical Mass Hypothesis
From the State University of New York Health Science Center at Syracuse, NY.
Correspondence to José Jalife, MD, Department of Pharmacology, SUNY Health Science Center, 766 Irving Ave, Syracuse, NY 13210. E-mail jalifej{at}vax.cs.hscsyr.edu
Abstract—The idea that
fibrillation is only possible in hearts exceeding a critical size was
introduced by W. Garrey >80 years ago and has since been generally
accepted. In ventricular tissue, this critical size was
originally estimated to be 400 mm2. Recent estimates
suggest that the critical size required for sustained reentry is 
100
to 200 mm2, whereas 6 times this area is required for
ventricular fibrillation. According to these estimates,
fibrillation is not possible in the mouse heart, where the
ventricular surface area is 100 mm2. To
test whether sustained ventricular fibrillation could be
induced in such an area, we used a high-speed video imaging system and
a voltage-sensitive dye to quantify electrical activity on the
epicardial surface of the Langendorff-perfused adult mouse heart. In 6
hearts, measurements during ventricular pacing at a basic
cycle length (BCL) of 120 ms yielded maximum and minimum conduction
velocities (CVmax and CVmin) of 0.63±0.04 and
0.38±0.02 mm/ms, respectively. At a BCL of 80 ms,
CVmax and CVmin changed to 0.55±0.03 and
0.34±0.02 mm/ms. Action potential durations (APDs), measured at
70% repolarization at those pacing frequencies were found to be
44.5±2.9 and 40.4±2.6 ms, respectively. The wavelengths (CVxAPD)
were calculated to be 28.6±3.4 mm in the CVmax
direction and 16.8±1.5 mm in the CVmin direction at
BCL 120 ms. Wavelengths were significantly reduced
(P<0.05) at BCL 80 ms (CVmax,
22.2±1.8 mm; CVmin, 13.7±0.9 mm). In 5 hearts,
stationary vortex-like reentry organized by single rotors (4 of 5
hearts) or by pairs of rotors (1 of 5 hearts) was induced by burst
pacing. In the ECG, the activity manifested as sustained monomorphic
tachycardia. Detailed analysis showed that the
local CVs were reduced in the vicinity of the rotor center, which
allowed the reentry to take place within a smaller area than was
calculated from wavelength measurements during pacing. In 4 of 7
hearts, burst pacing resulted in a polymorphic ECG pattern
indistinguishable from ventricular fibrillation. These data
challenge the critical mass hypothesis by demonstrating that
ventricular tissue with an area as small as 100
mm2 is capable of undergoing sustained fibrillatory
activity.
Key Words: rotor • vortex-like reentry • curvature • wavelength • conduction velocity
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