Spatial organization, predictability, and determinism in ventricular fibrillation.
ABSTRACT The degree of spatial organization of ventricular fibrillation (VF) is a fundamental dynamical property of the arrhythmia and may determine the success of proposed therapeutic approaches. Spatial organization is closely related to the dimension of VF, and hence to its predictability and controllability. We have explored several techniques to quantify spatial organization during VF, to predict patterns of activity, and to see how spatial organization and predictability change as the arrhythmia progresses. Epicardial electrograms recorded from pig hearts using rectangular arrays of unipolar extracellular electrodes (1 mm spacing) were analyzed. The correlation length of VF, the number of Karhunen-Loeve modes required to approximate data during VF, the number, size and recurrence of wavefronts, and the mean square error of epicardial potential fields predicted 0.256 seconds into the future were all estimated. The ability of regularly-timed pacing stimuli to capture areas of fibrillating myocardium during VF was confirmed by a significant increase in local spatial organization. Results indicate that VF is neither "low-dimensional chaos" (dimension <5) nor "random" behavior (dimension= infinity ), but is a high-dimensional response with a degree of spatial coherence that changes as the arrhythmia progresses. (c) 1998 American Institute of Physics.
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ABSTRACT: Ventricular fibrillation (VF) is the leading cause of sudden cardiac death. This brief review addresses issues relevant to the dynamics of the rotors responsible for functional reentry and VF. It also makes an attempt to summarize present-day knowledge of the manner in which the dynamic interplay between inward and outward transmembrane currents and the heterogeneous cardiac structure establish a substrate for the initiation and maintenance of rotors and VF. The fragmentary nature of our current understanding of ionic VF mechanisms does not even allow an approach toward a "Theory of VF". Yet some hope is provided by recently obtained insight into the roles played in VF by some of the sarcolemmal ion channels that control the excitation-recovery process. For example, strong evidence supports the idea that the interplay between the rapid-inward sodium current and the inward-rectifier potassium current controls rotor formation, as well as rotor stability and frequency. Solid evidence also exists for an involvement of L-type calcium current in the control of rotor frequency and in determining VF-to-ventricular tachycardia conversion. Less clear, however, is whether or not time dependent outward currents through voltage-gated potassium channels affect the fibrillatory process. Hopefully, taking advantage of currently available approaches of structural, molecular and cellular biology, together with computational and imaging techniques, will afford us the opportunity to further advance knowledge on VF mechanisms.Circulation Journal 01/2007; 71 Suppl A:A1-11. · 3.58 Impact Factor
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ABSTRACT: Ventricular fibrillation (VF) in the human heart is not well understood. The aim of this study was to measure changes in the phase relationship between the body surface ECG and intracardiac electrograms recorded during the first 10 s of human VF. We studied 11 episodes of VF and measured the coherence of (a) ECG lead I and ECG lead V1, (b) ECG lead V1 and the right ventricular apex (RVA) electrogram, and (c) ECG lead V1 and the smoothed RVA electrogram. Each coherence measurement was the average of the magnitude squared coherence function in the range 0-60 Hz, and measurements were made 1, 3, 5, 7 and 9 s after the onset of VF. Overall, the mean (SD) coherence was 31(6)% between ECG leads I and V1, 17(3)% between ECG lead V1 and the RVA electrogram, and 20(4)% between ECG lead V1 and the smoothed RVA electrogram. All three measurements of coherence increased significantly between 1 and 9 s with mean (SD) rates of 0.97(1.01)% s(-1), 0.8(1.18)% s(-1) and 0.82(1.19)% s(-1) respectively. These results show that propagation in human VF becomes more organized during the first 10 s of VF. This may be an optimal window for defibrillation.Physiological Measurement 06/1999; 20(2):159-66. · 1.50 Impact Factor
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ABSTRACT: The variability of meteorological observables is known to crucially depend on the geographical conditions and the considered spatial as well as temporal scales. In this contribution, we explicitly take the spatial dimension into account. Recent studies on this aspect have considered individual investigations of spatially distributed records from different stations, which form network structures with interesting statistical properties. However, the results of such studies are strongly influenced by the preprocessing of the time series, in the case of temperature records particularly by the applied deseasonalisation strategy. As a complementary approach, we investigate whether the interdependences between pairs of meteorological records can be used to extract additional information about the regularity of temporal variations of the regional climate and its potential change with time. As an alternative to the consideration of univariate estimates of fractal dimensions, the concept of multivariate dimension estimates is introduced. Different quantitative measures for the complexity of linear correlations are introduced and thoroughly compared. After studying the results for stationary model systems, our approach is used to characterise the variability of temperature records from 13 Japanese meteorological stations. The complexity of the complete record varies on an annual period with a larger complexity during the summer season, which is possibly related to the action of the East Asian monsoonal circulation.08/2008: pages 125-154;