PMID- 15028055
OWN - NLM
STAT- MEDLINE
DCOM- 20041106
LR  - 20071114
IS  - 1045-3873 (Print)
IS  - 1045-3873 (Linking)
VI  - 15
IP  - 2
DP  - 2004 Feb
TI  - Spiral wave control by a localized stimulus: a bidomain model study.
PG  - 226-33
AB  - INTRODUCTION: It has been reported that electrical stimulation can control spiral 
      wave (SW) reentry. However, previous research does not account for the effects of 
      stimulus-induced virtual electrode polarization (VEP) and the ensuing 
      cathode-break (CB) excitation. The aim of the present study was to examine the 
      interaction of VEP with SW reentry in a bidomain model of electrical stimulation 
      and thus provide insight into the mechanistic basis of SW control. METHODS AND 
      RESULTS: We conducted 3,168 simulations of localized stimulation during SW 
      reentry in an anisotropic bidomain sheet. Unipolar cathodal 2-ms stimuli of 
      strengths 4, 8, 16, and 24 mA were delivered at 99 locations in the sheet. The 
      interaction between stimulus-induced VEP and SW reentry resulted in 1 of 3 
      possible outcomes: SW shift, SW breakup, or no effect. SW shift, which could be 
      instrumental in SW termination at an anatomic or functional line of block, 
      resulted from CB rather than cathode-make excitation. Stimulus timing, site, and 
      strength all were important factors in VEP-mediated SW control. Furthermore, we 
      found that the number of episodes of SW shift across the fibers was more 
      sensitive to stimulus strength than that of SW shift along the fibers. SW shift 
      can be explained by the interaction between the four VEP-induced wavebreaks and 
      the wavebreak of the SW, ultimately resulting in termination of the original SW 
      and the survival of one of the VEP-induced wavebreaks. This establishes a new SW 
      reentry. CONCLUSION: This study provides new mechanistic insight into SW control.
FAU - Ashihara, Takashi
AU  - Ashihara T
AD  - Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana 
      70118, USA. tashihar@tulane.edu
FAU - Namba, Tsunetoyo
AU  - Namba T
FAU - Ito, Makoto
AU  - Ito M
FAU - Ikeda, Takanori
AU  - Ikeda T
FAU - Nakazawa, Kazuo
AU  - Nakazawa K
FAU - Trayanova, Natalia
AU  - Trayanova N
LA  - eng
GR  - HL063196/HL/NHLBI NIH HHS/United States
GR  - HL067322/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
MH  - Atrial Fibrillation/physiopathology
MH  - Computer Simulation
MH  - Differential Threshold
MH  - Electric Conductivity
MH  - Electric Stimulation
MH  - Electrodes
MH  - Electrophysiologic Techniques, Cardiac
MH  - Evoked Potentials/physiology
MH  - Heart/*physiology
MH  - Heart Conduction System/physiopathology
MH  - Humans
MH  - Membrane Potentials/physiology
MH  - Models, Cardiovascular
MH  - Myocardium/chemistry
MH  - Time Factors
EDAT- 2004/03/19 05:00
MHDA- 2004/11/09 09:00
CRDT- 2004/03/19 05:00
PHST- 2004/03/19 05:00 [pubmed]
PHST- 2004/11/09 09:00 [medline]
PHST- 2004/03/19 05:00 [entrez]
AID - JCE03381 [pii]
AID - 10.1046/j.1540-8167.2004.03381.x [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2004 Feb;15(2):226-33. doi: 
      10.1046/j.1540-8167.2004.03381.x.