Kuijpers N H L, Keldermann R H, Arts T, Hilbers P A J
Department of Biomedical Engineering, Technische Universiteit Eindhoven, The Netherlands.
Europace. 2005 Sep;7 Suppl 2:166-77. doi: 10.1016/j.eupc.2005.03.021.
The aim of the present study is to investigate the origin and effect of virtual electrode polarization in uniform, decoupled and non-uniform cardiac tissue during field stimulation.
A discrete bidomain model with active membrane behaviour was used to simulate normal cardiac tissue as well as cardiac tissue that is decoupled due to fibrosis and gap junction remodelling. Various uniform and non-uniform electric fields were applied to the external domain of uniform, decoupled and non-uniform resting cardiac tissue as well as cardiac tissue in which spiral waves were induced.
Field stimulation applied on non-uniform tissue results in more virtual electrodes compared with uniform tissue. The spiral waves were terminated in decoupled tissue, but not in uniform, homogeneous tissue. By gradually increasing local differences in intracellular conductivities, the amount and spread of virtual electrodes increased and the spiral waves were terminated.
Fast depolarization of the tissue after field stimulation may be explained by intracellular decoupling and spatial heterogeneity present in normal and pathological cardiac tissue. We demonstrated that termination of spiral waves by means of field stimulation can be achieved when the tissue is modelled as a non-uniform, anisotropic bidomain with active membrane behaviour.
本研究旨在探讨电场刺激期间均匀、解耦和非均匀心脏组织中虚拟电极极化的起源和影响。
使用具有活性膜行为的离散双域模型来模拟正常心脏组织以及因纤维化和缝隙连接重塑而解耦的心脏组织。将各种均匀和非均匀电场施加到均匀、解耦和非均匀静息心脏组织以及诱导出螺旋波的心脏组织的外部区域。
与均匀组织相比，施加在非均匀组织上的电场刺激会产生更多的虚拟电极。螺旋波在解耦组织中终止，但在均匀、均质组织中不会终止。通过逐渐增加细胞内电导率的局部差异，虚拟电极的数量和传播范围增加，螺旋波终止。
电场刺激后组织的快速去极化可能由正常和病理心脏组织中存在的细胞内解耦和空间异质性来解释。我们证明，当将组织建模为具有活性膜行为的非均匀、各向异性双域时，可通过电场刺激实现螺旋波的终止。
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