Imaging of Ventricular Fibrillation and Defibrillation: The Virtual Electrode Hypothesis.
Imaging of Ventricular Fibrillation and Defibrillation: The Virtual Electrode Hypothesis.
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心室颤动和除颤的成像：虚拟电极假说。
DOI：
10.1007/978-3-319-17641-3_14
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发表时间：
2015
影响因子：
--
通讯作者：
Efimov,IgorR
中科院分区：
文献类型：
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作者：
Boukens,BastiaanJ;Gutbrod,SarahR;Efimov,IgorR
室颤是心源性猝死的主要潜在原因。要了解导致室颤的复杂的激活模式，需要高分辨率的局部激活标测。多电极标测的使用揭示了室颤背后的折返性激活模式。然而，光学标测有助于理解除颤的机制，在除颤中，多电极记录无法测量电击过程中和电击后立即的激活模式。此外，光学标测将刺激和除颤脉冲期间产生的虚拟电极可视化，这有助于提出虚拟电极假说。在除颤过程中产生的虚拟电极诱导的相位奇点是致心律失常的，并且可能导致除颤之后的纤颤的诱发。低能量的除颤可以绕过这个问题。因此，目前的挑战是利用光学标测提供的知识来开发一种低能量的除颤方法，这可能会导致更成功的除颤。
Ventricular fibrillation is the major underlying cause of sudden cardiac death. Understanding the complex activation patterns that give rise to ventricular fibrillation requires high resolution mapping of localized activation. The use of multi-electrode mapping unraveled re-entrant activation patterns that underlie ventricular fibrillation. However, optical mapping contributed critically to understanding the mechanism of defibrillation, where multi-electrode recordings could not measure activation patterns during and immediately after a shock. In addition, optical mapping visualizes the virtual electrodes that are generated during stimulation and defibrillation pulses, which contributed to the formulation of the virtual electrode hypothesis. The generation of virtual electrode induced phase singularities during defibrillation is arrhythmogenic and may lead to the induction of fibrillation subsequent to defibrillation. Defibrillating with low energy may circumvent this problem. Therefore, the current challenge is to use the knowledge provided by optical mapping to develop a low energy approach of defibrillation, which may lead to more successful defibrillation.