Evaluating Intramural Virtual Electrodes in the Myocardial Wedge Preparation: Simulations of Experimental Conditions
Gernot Plank 1, Anton J Prassl 1, Ernst Hofer 1 and Natalia A Trayanova 2*
1 Medical University of Graz
2 Johns Hopkins University
* To whom correspondence should be addressed. E-mail: ntrayanova{at}jhu.edu.
Submitted on September 5, 2007
Revised on October 16, 2007
Accepted on 24 October 2007
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Abstract |
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While defibrillation is the only means for prevention of sudden cardiac death, key aspects of the process, such as the intramural virtual electrodes (VEs), remain controversial. Experimental studies had attempted to assess intramural VEs by using wedge preparations and recording activity from the cut surface, however applicability of this approach remains unclear. These studies found, surprisingly, that for strong shocks, the entire cut surface was negatively polarized, regardless of boundary conditions. The goal of this study is to examine, by means of bidomain simulations, whether VEs on the cut surface represent a good approximation to VEs in depth of the intact wall. Furthermore, we aim to explore mechanisms that could give rise to negative polarization on the cut surface. A model of wedge preparation was used, in which fiber orientation could be changed, and where the cut surface was subjected to permeable and impermeable boundary conditions. Small-scale mechanisms for polarization were also considered. To determine whether any distortions in the recorded VEs arise from averaging during optical mapping, model of fluorescent recording was employed. The results indicate that when applied field is spatially uniform and impermeable boundary conditions are enforced, regardless of fiber orientation, VEs on the cut surface faithfully represent those intramurally, provided tissue properties are not altered by dissection. Results also demonstrate that VEs are sensitive to the conductive layer thickness above the cut surface. Finally, averaging during fluorescent recordings results in large negative VEs on the cut surface, but these do not arise from small-scale heterogeneities.
Key Words:
boundary conditions, computer simulation, electric shocks, myocardial wedge preparation, optical mappping, virtual electrodes
