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(Circulation Research. 2002;91:733.)
© 2002 American Heart Association, Inc.

Integrative Physiology

Regional Differences in Ventricular Fibrillation in the Open-Chest Porcine Left Ventricle

Kumaraswamy Nanthakumar, Jian Huang, Jack M. Rogers, Philip L. Johnson, Jonathan C. Newton, Greg P. Walcott, Robert K. Justice, Dennis L. Rollins, William M. Smith, Raymond E. Ideker

From the University of Alabama at Birmingham, Birmingham, Ala.

Correspondence to Raymond E. Ideker, MD, PhD, University of Alabama at Birmingham, 1670 University Blvd, B140 Volker Hall, Birmingham, AL 35294-0019. E-mail rei{at}crml.uab.edu

It has been hypothesized that during ventricular fibrillation (VF), the fastest activating region, the dominant domain, contains a stable reentrant circuit called a mother rotor. This hypothesis postulates that the mother rotor spawns wavefronts that propagate to maintain VF elsewhere and implies that the ratio of wavefronts propagating off a region to those propagating onto it (propoff/propon) should be >1 for the dominant domain but <1 elsewhere. To test this prediction in the left ventricular (LV) epicardium of a large animal, most of the LV free wall was mapped with 1008 electrodes in 7 pigs. VF activation rate was faster in the posterior than in the anterior LV (10.0±1.3Hz versus 9.3±1.3Hz; P<0.001). The anterior LV had a higher fraction of wavefronts that blocked than did the posterior LV and had a propoff/propon ratio <1 (P<0.001). The mean conduction velocity vectors of the VF wavefronts pointed in the direction from the posterior to the anterior LV. Although these findings favor a dominant domain in the posterior LV, the facts that the anterior LV had a higher incidence of reentry than did the posterior LV and that the posterior LV did not have propoff/propon significantly different from 1 do not. Thus, quantitative regional differences are present over the porcine LV epicardium during VF. Although these differences are not totally consistent with the presence of a dominant domain within the LV free wall, the mean conduction velocity vector is consistent with one in the septum.

Key Words: ventricular fibrillation • electrical mapping • mechanisms of arrhythmias

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