Effect of a bath on the epicardial transmembrane potential during internal defibrillation shocks.

Using a three-dimensional model of cardiac tissue, we consider a rectangular slab of tissue. We examine the effect of a defibrillating shock from an intracavitary electrode upon the epicardial transmembrane potential (Vm) for two cases: one in which the epicardium is bounded by air and another in which it is bounded by a conductive bath. We find that the inclusion of the bath changes the polarity of the steady-state Vm in the epicardial region that is closest to the shock electrode. In addition, the magnitude of Vm is increased dramatically if the bath is present; the degree of hyperpolarization increases twenty-fivefold, while the degree of depolarization increases elevenfold. The remaining bulk of the cardiac tissue is relatively unaffected by the inclusion of the bath.