Department of Biomedical Engineering, Johns Hopkins University School of Medicine, 3400 N Charles Street, 216 Hackerman Hall, Baltimore, MD 21218, USA.
Europace. 2014 May;16(5):705-13. doi: 10.1093/europace/eut330.
Cardiac defibrillation, as accomplished nowadays by automatic, implantable devices, constitutes the most important means of combating sudden cardiac death. Advancing our understanding towards a full appreciation of the mechanisms by which a shock interacts with the heart, particularly under diseased conditions, is a promising approach to achieve an optimal therapy. The aim of this article is to assess the current state-of-the-art in whole-heart defibrillation modelling, focusing on major insights that have been obtained using defibrillation models, primarily those of realistic heart geometry and disease remodelling. The article showcases the contributions that modelling and simulation have made to our understanding of the defibrillation process. The review thus provides an example of biophysically based computational modelling of the heart (i.e. cardiac defibrillation) that has advanced the understanding of cardiac electrophysiological interaction at the organ level, and has the potential to contribute to the betterment of the clinical practice of defibrillation.
心脏除颤，如现今通过自动植入设备来实现，是对抗心源性猝死最重要的手段。深入了解电击与心脏相互作用的机制，尤其是在患病情况下，是实现最佳治疗的有前途的方法。本文的目的是评估整体心脏除颤建模的最新技术，重点是使用除颤模型获得的主要见解，主要是那些具有现实心脏几何形状和疾病重塑的模型。本文展示了建模和模拟对我们理解除颤过程的贡献。因此，该综述提供了一个基于生物物理的心脏计算模型（即心脏除颤）的例子，该模型提高了对器官水平心脏电生理相互作用的理解，并有可能有助于改善除颤的临床实践。
