Departments of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
Annu Rev Biomed Eng. 2010 Aug 15;12:233-58. doi: 10.1146/annurev-bioeng-070909-105305.
Electrical shock has been the one effective treatment for ventricular fibrillation for several decades. With the advancement of electrical and optical mapping techniques, histology, and computer modeling, the mechanisms responsible for defibrillation are now coming to light. In this review, we discuss recent work that demonstrates the various mechanisms responsible for defibrillation. On the cellular level, membrane depolarization and electroporation affect defibrillation outcome. Cell bundles and collagenous septae are secondary sources and cause virtual electrodes at sites far from shocking electrodes. On the whole-heart level, shock field gradient and critical points determine whether a shock is successful or whether reentry causes initiation and continuation of fibrillation.
电击治疗室颤已有几十年的历史，是唯一有效的治疗方法。随着电和光学绘图技术、组织学和计算机建模的进步，现在越来越清楚是什么机制导致除颤。在这篇综述中，我们讨论了最近的工作，这些工作证明了导致除颤的各种机制。在细胞水平上，细胞膜去极化和电穿孔会影响除颤效果。细胞束和胶原隔片是次要的来源，在远离电击电极的部位产生虚拟电极。在整个心脏水平上，刺激场梯度和关键点决定了刺激是否成功，或者折返是否导致纤维性颤动的开始和持续。
