Articles |
From the Division of Cardiovascular Disease of the School of Medicine and Department of Biomedical Engineering, The University of Alabama, Birmingham.
Correspondence to Stephen B. Knisley, PhD, The University of Alabama at Birmingham, G82A Volker Hall, 1670 University Blvd, Birmingham, AL 35294-0019. E-mail sbk@crml.uab.edu.
Abstract This study tested the prediction of bidomain models
that unipolar stimulation of anisotropic myocardium
produces transmembrane voltage changes (
Vms) of opposite
signs away from the electrode on perpendicular axes. Stimulation with a
strength of 0.1 to 40 mA was applied from a point electrode on the left
or right ventricle of isolated perfused rabbit hearts at 37°C to
38°C stained with the potentiometric dye di-4-ANEPPS. A laser scanner
system recorded Vm-sensitive fluorescence at 63
spots in an 8x8-mm region around the electrode. Cathodal stimulation
in the refractory period produced regions of -
Vm 1
to 5 mm away from the electrode on an axis oriented parallel to the
fast propagation axis to within 1.8±11° (P
.7 for
difference versus zero, n=7). Recording spots in these regions
underwent +
Vm when anodal stimulation was used. At
recording spots on the slow propagation axis, cathodal
stimulation produced +
Vm and anodal stimulation produced
-
Vm. During diastolic stimulation,
early excitation occurred near the electrode for cathodal stimulation
or on the fast propagation axis as far as 2.8±1 mm away from the
electrode for anodal stimulation. A "dog-bone" region of
+
Vm that included tissue near and away from the
electrode on the slow propagation axis occurred when cathodal
stimulation was given in diastole. Regions of
+
Vm occurred away from the electrode on the
fast propagation axis when anodal stimulation was given in
diastole. Thus,
Vm differs in regions along
and across myocardial fibers, indicating that
Vm depends
on anisotropic bidomain properties. Sites of early excitation are those
where +
Vm occurs, indicating that membrane channel
excitation depends on the distribution of
Vm.
Key Words: heart electrical stimulation cardiac pacing voltage-sensitive fluorescent dye di-4-ANEPPS
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