© 1999 American Heart Association, Inc.
Original Contribution |
Electrical Restitution and Spatiotemporal Organization During Ventricular Fibrillation
From the Department of Physiology (M.L.R., M.L.K., R.F.G.), Cornell University, Ithaca, NY, and Department of Medicine (M.L.K.), University of Würzburg, Germany
Correspondence to Robert F. Gilmour, Jr, Department of Physiology, T8 012B VRT, Cornell University, Ithaca, NY 14853-6401.
Abstract—Despite recent advances
in our understanding of the mechanism for ventricular
fibrillation (VF), important
electrophysiological aspects of the
development of VF still are poorly defined. It has been suggested that
the onset of VF involves the disintegration of a single spiral wave
into many self-perpetuating waves. It has been further suggested that
such a process requires that the slope of the electrical restitution
relation be 
1. The same theory anticipates that a single spiral wave
will be stable (not disintegrate) if the maximum slope of the
restitution relation is <1. We have shown previously that the slope of
the restitution relation during rapid pacing and during VF is 1 in
canine ventricle. We now show that drugs that reduce the slope of the
restitution relation (diacetyl monoxime and verapamil)
prevent the induction of VF and convert existing VF into a periodic
rhythm. In contrast, a drug that does not reduce the slope of the
restitution relation (procainamide) does not prevent the
induction of VF, nor does it regularize VF. These results indicate that
the kinetics of electrical restitution is a key determinant of VF.
Moreover, they suggest novel approaches to preventing the induction or
maintenance of VF.
Key Words: restitution • action potential duration • ventricular fibrillation • defibrillation
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A. V. Zaitsev, O. Berenfeld, S. F. Mironov, J. Jalife, and A. M. Pertsov Distribution of Excitation Frequencies on the Epicardial and Endocardial Surfaces of Fibrillating Ventricular Wall of the Sheep Heart Circ. Res., March 3, 2000; 86(4): 408 - 417. [Abstract] [Full Text] [PDF]
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A. Garfinkel, Y.-H. Kim, O. Voroshilovsky, Z. Qu, J. R. Kil, M.-H. Lee, H. S. Karagueuzian, J. N. Weiss, and P.-S. Chen From the Cover: Preventing ventricular fibrillation by flattening cardiac restitution PNAS, May 23, 2000; 97(11): 6061 - 6066. [Abstract] [Full Text] [PDF]
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D. J. Christini, K. M. Stein, S. M. Markowitz, S. Mittal, D. J. Slotwiner, M. A. Scheiner, S. Iwai, and B. B. Lerman Nonlinear-dynamical arrhythmia control in humans PNAS, May 8, 2001; 98(10): 5827 - 5832. [Abstract] [Full Text] [PDF]
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M. A. Watanabe and M. L. Koller Mathematical analysis of dynamics of cardiac memory and accommodation: theory and experiment Am J Physiol Heart Circ Physiol, April 1, 2002; 282(4): H1534 - H1547. [Abstract] [Full Text] [PDF]
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Y. Cheng, K. A. Mowrey, V. Nikolski, P. J. Tchou, and I. R. Efimov Mechanisms of shock-induced arrhythmogenesis during acute global ischemia Am J Physiol Heart Circ Physiol, June 1, 2002; 282(6): H2141 - H2151. [Abstract] [Full Text] [PDF]
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J. J. Fox, J. L. McHarg, and R. F. Gilmour Jr Ionic mechanism of electrical alternans Am J Physiol Heart Circ Physiol, February 1, 2002; 282(2): H516 - H530. [Abstract] [Full Text] [PDF]
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M. Swissa, Z. Qu, T. Ohara, M.-H. Lee, S.-F. Lin, A. Garfinkel, H. S. Karagueuzian, J. N. Weiss, and P.-S. Chen Action potential duration restitution and ventricular fibrillation due to rapid focal excitation Am J Physiol Heart Circ Physiol, May 1, 2002; 282(5): H1915 - H1923. [Abstract] [Full Text] [PDF]
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M. Valderrabano, J. Yang, C. Omichi, J. Kil, S. T. Lamp, Z. Qu, S.-F. Lin, H. S. Karagueuzian, A. Garfinkel, P.-S. Chen, et al. Frequency Analysis of Ventricular Fibrillation in Swine Ventricles Circ. Res., February 8, 2002; 90(2): 213 - 222. [Abstract] [Full Text] [PDF]
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J. J. Fox, M. L. Riccio, F. Hua, E. Bodenschatz, and R. F. Gilmour Jr Spatiotemporal Transition to Conduction Block in Canine Ventricle Circ. Res., February 22, 2002; 90(3): 289 - 296. [Abstract] [Full Text] [PDF]
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