L. M. Popp, G. Seemann, and O. Dössel. A simulation study of the reaction of human heart to biphasic electrical shocks. In BMC Cardiovascular Disorders, vol. 4, pp. 9, 2004
BACKGROUND: This article presents a study, which examines the effects of biphasic electrical shocks on human ventricular tissue. The effects of this type of shock are not yet fully understood. Animal experiments showed the superiority of biphasic shocks over monophasic ones in defibrillation. A mathematical computer simulation can increase the knowledge of human heart behavior. METHODS: The research presented in this article was done with different models representing a three-dimensional wedge of ventricular myocardium. The electrophysiology was described with Priebe-Beuckelmann model. The realistic fiber twist, which is specific to human myocardium was included. Planar electrodes were placed at the ends of the longest side of the virtual cardiac wedge, in a bath medium. They were sources of electrical shocks, which varied in magnitude from 0.1 to 5 V. In a second arrangement ring electrodes were placed directly on myocardium for getting a better view on secondary electrical sources. The electrical reaction of the tissue was generated with a bidomain model. RESULTS: The reaction of the tissue to the electrical shock was specific to the initial imposed characteristics. Depolarization appeared in the first 5 ms in different locations. A further study of the cardiac tissue behavior revealed, which features influence the response of the considered muscle. It was shown that the time needed by the tissue to be totally depolarized is much shorter when a biphasic shock is applied. Each simulation ended only after complete repolarization was achieved. This created the possibility of gathering information from all states corresponding to one cycle of the cardiac rhythm. CONCLUSIONS: The differences between the reaction of the homogeneous tissue and a tissue, which contains cleavage planes, reveals important aspects of superiority of biphasic pulses.
Conference Contributions (5)
I. M. Popp, G. Seemann, and O. Dössel. The reaction of a fibrillating myocardium to electrical shocks of different durations. In Proc. BMT, vol. 49-2/1, pp. 376-377, 2004
Defibrillation of the heart is used widely to resuscitate pa tients with fibrillating heart, being the most effective ther apy for this otherwise lethal disturbance of cardiac rhythm. The basic electrophysilogical mechanisms of this proce dure are not well understood. The aim of this work is to in vestigate the conditions that influence the so called virtual electrodes that appear in human ventricular myocardium and also their effects. A two-dimensional and a three dimensional computer model of cardiac tissue is used. For this the temporal evolution of the transmembrane voltage is studied until the entire tissue is repolarized, the needed time interval being around 400 ms.
I. M. Popp, G. Seemann, and O. Dössel. Investigation of electrical defibrillation of chaotically fibrillating human ventricular myocardium in a computer model. In Proceedings of the 31st International Congress on Electrocardiology, pp. 148-151, 2004
Defibrillation is the most important measure of resuscitation aiming at restoration of the physiological heart rhythm. A complete understanding of the defibrillation mechanism has not been achieved yet. The research presented in this article gives a mathematical computer simulation of the defibrillation of chaotically fibrillating human ventricular myocardium. The study was done with a model representing a three-dimensional wedge of human ventricular myocardial tissue. The cellular electrophysiology was described with the Priebe-Beuckelmann model. The electrical activity of the cardiac tissue was calculated with a bidomain model. A spiral wave was induced in the myocardium with standard S1-S2 protocols. The myocardium was brought into a chaotically fibrillating state by breaking the spiral wave. Few hundred milliseconds after the chaotically fibrillation started, monophasic electrical defibrillating shocks were applied through planar electrodes. The defibrillation shocks were applied at different moments. At each chosen moment we studied both cases of electrical polarity. The reaction of myocardium was studied during the following 400 ms. The results are indicating important information related to the factors, which are influencing the defibrillation success.
I. M. Popp, G. Seemann, and O. Dössel. Investigation of the influence of electric fields on human ventricular myocardium including realistic fiber orientation: a simulation study. In Computers in Cardiology, pp. 213-216, 2003
The aim of this work is to enlarge the knowledge about the electrophysiological phenomena that describes the defibrillation procedure. We simulated this using a three-dimensional computer model in which the human cardiac tissue is incorporated in blood bath medium. Two initial situations were imposed: the tissue being in a resting state and the tissue being half resting, half depolarized, before the electrical shock was applied. For obtaining a more detailed look over these situations we varied the fiber orientation and the magnitude of the electrical impulse. The effects of intracellular electrical discontinuities represented an important target in our study. The temporal evolution of the transmembrane voltage was always followed until the tissue went back into the resting phase.