Department of Biomedical Sciences, Cornell University, Ithaca, NY 14853, USA.
IEEE Trans Biomed Eng. 2011 Jul;58(7):2013-22. doi: 10.1109/TBME.2011.2126044. Epub 2011 Mar 10.
Several different types of rapid cardiac rhythm disorders, including atrial and ventricular fibrillation, are likely caused by multiple, rapidly rotating, action potential (AP) waves. Thus, an electrical pacing therapy, whose effectiveness is based on being delivered with a particular timing relative to one of these waves, is unlikely to be useful in terminating the remaining waves. Here, we develop pacing protocols that are designed to terminate rotating waves independently of when the sequences of stimuli are imposed or where each wave is in its rotation at the time the sequences are initiated. These protocols are delivered as far-field stimuli, and therefore are capable of simultaneously influencing all the waves present. The pacing intervals for these protocols are, in general, of unequal duration and are determined through examination of the dynamics of AP propagation in a 1-D ring model. Series of two or three stimuli with interstimulus intervals chosen in this way are shown to be effective in terminating these waves over a wide range of ring circumferences and AP dynamical parameters. Stimulus sequences of this type may form the basis for developing new defibrillation protocols to test in experiments or more realistic models of the electrical heart.
几种不同类型的快速心律失常，包括心房和心室颤动，可能是由多个快速旋转的动作电位 (AP) 波引起的。因此，一种基于相对于这些波之一的特定时间进行传递的电起搏治疗不太可能用于终止剩余的波。在这里，我们开发了起搏方案，旨在独立于刺激序列施加的时间或在刺激序列启动时每个波在旋转中的位置来终止旋转波。这些方案作为远场刺激传递，因此能够同时影响存在的所有波。这些方案的起搏间隔通常具有不同的持续时间，并通过检查一维环模型中的 AP 传播动力学来确定。以这种方式选择的两个或三个刺激的系列刺激显示在广泛的环周长和 AP 动力学参数范围内有效终止这些波。这种类型的刺激序列可能为开发新的除颤协议奠定基础，以便在实验或更现实的心脏电模型中进行测试。
