Gurev V, Maleckar MM, Trayanova NA. Cardiac defibrillation and the role of mechanoelectric feedback in postshock arrhythmogenesis.
Ann N Y Acad Sci 2007;
1080:320-33. [PMID:
17132792 PMCID:
PMC2925201 DOI:
10.1196/annals.1380.024]
[Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Ventricular dilatation increases the defibrillation threshold (DFT). In order to elucidate the mechanisms responsible for this increase, the present article investigates changes in the postshock behavior of the myocardium upon stretch. A two-dimensional electro-mechanical model of cardiac tissue incorporating heterogeneous fiber orientation was used to explore the effect of sustained stretch on postshock behavior via (a) recruitment of mechanosensitive channels (MSC) and (b) tissue deformation and concomitant changes in tissue conductivities. Recruitment of MSC had no influence on vulnerability to electric shocks as compared to control, but increased the complexity of postshock VF patterns. Stretch-induced deformation and changes in tissue conductivities resulted in a decrease in vulnerability to electric shocks.
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