The Purkinje network plays a major role in low-energy ventricular defibrillation
The Purkinje network plays a major role in low-energy ventricular defibrillation
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DOI：
10.1016/j.compbiomed.2021.105133
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发表时间：
2021-12-23
影响因子：
7.7
通讯作者：
Vigmond, Edward J.
中科院分区：
文献类型：
--
作者：
Bayer, Jason D.;Sobota, Vladimir;Vigmond, Edward J.
背景：在心室颤动（VF）期间，利用低能量表面刺激靶向整个心肌的再入兴奋间隙（EG），有望实现无痛除颤。然而，浦肯野网络可能为重新进入提供替代途径以逃避终止。本研究探讨浦肯野神经网络在无痛除颤中的作用。方法：在具有浦肯野神经网络的计算人类双心室模型中，以4hz心外膜起搏启动VF。除颤是通过低能量2 ms脉冲刺激心肌表面EG，以2倍的刺激捕获，在心室颤动开始后0.25到5秒之间以0.25秒增加的耦合间隔进行。如果再入停止，则完成除颤
Background: During ventricular fibrillation (VF), targeting the excitable gap (EG) of reentry throughout the myocardium with low-energy surface stimulation shows promise for painless defibrillation. However, the Purkinje network may provide alternative pathways for reentry to evade termination. This study investigates the role of the Purkinje network in painless defibrillation.Methods: In a computational human biventricular model featuring a Purkinje network, VF was initiated with 4 Hz epicardial pacing. Defibrillation was attempted by stimulating myocardial surface EG with a low-energy 2 ms duration pulse at 2x stimulus capture, which was administered at coupling intervals incremented by 0.25 s between 0.25 and 5 s after VF initiation. Defibrillation was accomplished if reentry ceased