Defibrillation of the heart: insights into mechanisms from modelling studies

@article{Trayanova2006DefibrillationOT,
  title={Defibrillation of the heart: insights into mechanisms from modelling studies},
  author={Natalia A. Trayanova},
  journal={Experimental Physiology},
  year={2006},
  volume={91}
}
  • N. Trayanova
  • Published 2006
  • Computer Science, Medicine
  • Experimental Physiology
Despite its critical role in restoring cardiac rhythm and thus in saving human life, cardiac defibrillation remains poorly understood. Further mechanistic inquiry is hampered by the inability of presently available experimental techniques to resolve, with sufficient accuracy, electrical behaviour confined to the depth of the ventricles. The objective of this review article is to demonstrate that realistic 3‐D simulations of the ventricular defibrillation process in close conjunction with… Expand
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References

SHOWING 1-10 OF 69 REFERENCES
Computer simulations of cardiac defibrillation: a look inside the heart
TLDR
Two models of defibrillation are presented: a three-dimensional slice of the canine heart that encompasses both ventricular cavities, and a full rabbit heart model, which demonstrate transmural electrical activity in the heart during and after the shock. Expand
Advances in Modeling Cardiac Defibrillation
TLDR
A bidomain model of electrical defibrillation and post-shock arrhythmogenesis of the rabbit heart is presented that incorporates a realistic representation of cardiac geometry, fiber structure, and membrane ionic processes. Expand
Chapter 31 – Modeling Cardiac Defibrillation
Despite the large body of research devoted to ventricular defibrillation, the mechanisms by which a strong electric shock delivered to the heart terminates lethal disturbances in ventricular rhythmExpand
Concepts of ventricular defibrillation
  • N. Trayanova
  • Medicine
  • Philosophical Transactions of the Royal Society of London. Series A: Mathematical, Physical and Engineering Sciences
  • 2001
TLDR
The goal of this paper is to examine the current theories for defibrillation and re-entry induction, the new breakthroughs in the field, and the emerging new hypotheses. Expand
Extension of Refractoriness in a Model of Cardiac Defibrillation
This simulation study presents an inquiry into the mechanisms by which a strong electric shock halts life-threatening cardiac arrhythmias. It examines the "extension of refractoriness" hypothesis forExpand
Shock-induced arrhythmogenesis in the myocardium.
TLDR
The study examines the evolution of the postshock phase singularities (PSs) which represent the organizing centers of reentry and results demonstrate that the shock induces numerous PSs the majority of which vanish before the reentrant wavefronts associated with them complete half of a single rotation. Expand
Cardiac Microstructure: Implications for Electrical Propagation and Defibrillation in the Heart
TLDR
It is concluded that the laminar organization of myocytes determines unique electrical properties in three microstructurally defined directions at any point in the ventricular wall of the heart, and interlaminar clefts between layers of cardiomyocytes provide a substrate for bulk activation of the ventricles during defibrillation. Expand
Upper limit of vulnerability in a defibrillation model of the rabbit ventricles.
TLDR
The results demonstrate that shock-induced virtual electrode polarization (VEP) in the midmyocardium is weaker and more complex than VEP on the surfaces, where only 2 areas, one of positive and one of negative polarization, are induced. Expand
Postshock Arrhythmogenesis in a Slice of the Canine Heart
TLDR
The aim of this study was to examine the relationship between end‐shock PSs and the reentrant circuits established after failed defibrillation attempts as a function of shock strength and electrode configuration. Expand
Virtual Electrodes and Deexcitation: New Insights into Fibrillation Induction and Defibrillation
TLDR
Evidence suggesting that comprehending the role of negative polarization (hyperpolarization) also is crucial for understanding the response to a shock is reviewed, suggesting its importance in fibrillation induction and defibrillation. Expand
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