Table
of Contents
|
|
|
|
|
|
Preface |
xv |
|
|
List of Contributors |
xix |
|
|
Foreword |
xxiii |
|
PART I |
HISTORY |
|
|
1.1 |
History of
Cardiac Pacing |
3 |
|
|
Earl Bakken: One
Version of the First Pacemaker Story |
3 |
|
|
The Long List of
Inventions and Observations that Led to the Pacemaker |
4 |
|
|
Pulse Theory and
Observations that Bradycardia
Leads to Syncope |
4 |
|
|
Early Cardiac Pacing |
5 |
|
|
Internal Pacemakers |
6 |
|
|
Pacing for Nonsurgeons |
7 |
|
|
Power Innovations |
8 |
|
|
Programming |
8 |
|
|
Dual-Chamber Pacing |
9 |
|
|
Activity Rate
Responders |
10 |
|
|
Implantable Cardiac
Defibrillators |
10 |
|
|
Michel Mirowski |
10 |
|
|
Conclusion |
12 |
|
|
References |
12 |
|
1.2 |
History of
Defibrillation |
15 |
|
|
Introduction:
Defibrillation and its Creators |
15 |
|
|
Mysteries of Early
Research: Abdilgaard’s
Chickens and Kite’s Successes |
17 |
|
|
Elucidating the
Mechanism, Imagining the Cure |
22 |
|
|
Defibrillation: From
|
26 |
|
|
Defibrillation: AC
to DC, in America and Beyond |
30 |
|
|
Conclusion |
35 |
|
|
References |
38 |
|
1.3 |
Ventricular
Fibrillation: A Historical Perspective |
41 |
|
|
Introduction |
41 |
|
|
Concepts,
Instruments, and Institutions: Nineteenth-Century Legacy |
42 |
|
|
The Clinic and the
Laboratory |
44 |
|
|
Ventricular
Fibrillation: Experimental Evidence and Basic Concepts, 1880s–1920s |
47 |
|
|
From Wiggers to Moe:
The Multiple Wavelet Hypothesis |
52 |
|
|
Modern Concepts of
Ventricular Fibrillation |
53 |
|
|
Concluding Remarks |
54 |
|
|
References and Notes |
54 |
|
PART II |
THEORY
OF ELECTRIC STIMULATION AND DEFIBRILLATION |
|
|
2.1 |
The Bidomain Theory
of Pacing |
63 |
|
|
Introduction |
63 |
|
|
Unipolar Stimulation |
63 |
|
|
Make and Break
Excitation |
64 |
|
|
Strength-Interval
Curves |
71 |
|
|
No-Response
Phenomenon |
76 |
|
|
Effect of Potassium
on Pacing |
78 |
|
|
Time Dependence of
the Anodal and Cathodal
Refractory Periods |
79 |
|
|
Conclusion |
81 |
|
|
Acknowledgments |
81 |
|
|
References |
81 |
|
2.2 |
Bidomain Model of Defibrillation |
85 |
|
|
Introduction |
85 |
|
|
Advancements Leading
to the Development of the Bidomain
Model of Defibrillation |
86 |
|
|
Bidomain Equations and
Numerical Approaches for Large-Scale Simulations in Shock-Induced Arrhythmogenesis
and Defibrillation |
87 |
|
|
Governing Equations |
88 |
|
|
Computational
Considerations |
89 |
|
|
Numerical Schemes |
90 |
|
|
Linear Solvers |
91 |
|
|
Models of the Heart
in Vulnerability and Defibrillation Studies |
94 |
|
|
Description of
Myocardial Geometry and Fiber Architecture |
94 |
|
|
Representation of
Ionic Currents and Membrane Electroporation |
95 |
|
|
Shock Electrodes and Waveforms |
95 |
|
|
Arrhythmia Induction
with an Electric Shock and Defibrillation |
96 |
|
|
Postshock Activity in the
Ventricles |
97 |
|
|
VEP Induced by the
Shock in the 3D Volume of the Ventricles |
97 |
|
|
Postshock Activations in the
3D Volume of the Ventricles |
99 |
|
|
ULV and LLV |
100 |
|
|
Shock-Induced Phase
Singularities and Filaments |
102 |
|
|
Induction of
Arrhythmia with Biphasic Shocks |
102 |
|
|
Conclusion |
104 |
|
|
Acknowledgments |
105 |
|
|
References |
105 |
|
2.3 |
The Generalized Activating Function |
111 |
|
|
Introduction |
111 |
|
|
The Activating
Function |
112 |
|
|
The Generalized
Activating Function |
114 |
|
|
Examples |
116 |
|
|
Discussion |
124 |
|
|
Limitations |
125 |
|
|
Validation |
126 |
|
|
Conclusion |
126 |
|
|
Appendix |
126 |
|
|
References |
130 |
|
2.4 |
Theory of Electroporation |
133 |
|
|
Concept of Electroporation |
133 |
|
|
Physical Background
of Electroporation |
134 |
|
|
Pore Energy |
134 |
|
|
Pore Creation |
136 |
|
|
Pore Evolution |
137 |
|
|
Postshock Pore Shrinkage and
Coarsening |
138 |
|
|
Pore Resealing |
139 |
|
|
Mathematical
Modeling of Electroporation |
140 |
|
|
Advection-Diffusion
Equation |
140 |
|
|
Asymptotic Model of Electroporation |
141 |
|
|
Current–Voltage
Relationship of a Pore |
142 |
|
|
Example of the Electroporation
Process |
144 |
|
|
Governing Equation
for the Transmembrane
Potential |
144 |
|
|
Membrane Charging Phase |
145 |
|
|
Pore Creation
Phase |
145 |
|
|
Pore Evolution
Phase |
146 |
|
|
Postshock Pore
Shrinkage Phase |
148 |
|
|
Pore Repealing
Phase |
149 |
|
|
Effects of Shock Strength |
149 |
|
|
Limitations |
151 |
|
|
Conclusion |
153 |
|
|
Acknowledgment |
153 |
|
|
Appendix 1: Parameters of the Electroporation
Model |
154 |
|
|
Appendix 2: Numerical
Implementation |
155 |
|
|
References |
156 |
|
PART III |
ELECTRODE MAPPING
OF DEFIBRILLATION |
|
|
3.1 |
Critical Points and the Upper Limit of
Vulnerability for Defibrillation |
165 |
|
|
Introduction |
165 |
|
|
Mechanisms by which Shocks
Induce VF |
167 |
|
|
The Field-Recovery Critical Point |
169 |
|
|
Inconsistencies with the
Field-Recovery Critical Hypothesis for Defibrillation |
180 |
|
|
The Virtual Electrode Critical
Point |
182 |
|
|
Other Possible Mechanisms for
Defibrillation |
185 |
|
|
Acknowledgment |
185 |
|
|
References |
185 |
|
3.2 |
The Role of Shock-Induced Nonregenerative Depolarizations |
189 |
|
|
Brief Historical Perspectives |
189 |
|
|
The Era of Computerized Cardiac
Mapping: New Insights |
194 |
|
|
Initiation of VF by Electrical
Stimuli |
195 |
|
|
Different Proposed Hypotheses of
Defibrillation |
196 |
|
|
The Graded Response Hypothesis
of Fibrillation and Defibrillation |
199 |
|
|
Graded Response
Characteristics |
199 |
|
|
Conclusions and Future Directions |
211 |
|
|
Acknowledgment |
212 |
|
|
References |
212 |
|
PART IV |
OPTICAL MAPPING OF
STIMULATION AND DEFIBRILLATION |
|
|
4.1 |
Mechanisms of Isolated Cell Stimulation |
221 |
|
|
Introduction |
221 |
|
|
Transmembrane Potential (Vm)
Responses of an Isolated Cell |
222 |
|
|
Theoretical Framework of Field
Stimulation |
222 |
|
|
Experimental Responses During
Field Stimulation |
225 |
|
|
Single Cells versus Tissue
Responses: Similarities and Differences |
236 |
|
|
Field-Induced Responses of an
Isolated Cell-Pair: Sawtooth
Effect |
237 |
|
|
Theoretical Treatment of Sawtooth Effect |
238 |
|
|
Experimental Measurement of Sawtooth Effect |
239 |
|
|
Sawtooth Effect’s
Role in Tissue: “Fact or Fantasy” |
241 |
|
|
Effect of Electric Fields on
Intracellular Calcium |
243 |
|
|
Measurement of Intracellular Ca2+Transients
Using Fluorescent Probes |
244 |
|
|
Effect of Field Stimulation on Intracellular Ca2+
Transients at Rest |
244 |
|
|
Effect of Field Stimulation on Intracellular Ca2+
Transients During Plateau |
248 |
|
|
Implications of Field-Induced Ca2+
Gradients |
248 |
|
|
Conclusion |
249 |
|
|
References |
249 |
|
4.2 |
The Role of Microscopic Tissue Structure in
Defibrillation |
255 |
|
|
Introduction |
255 |
|
|
Possible Mechanisms of
Intramural Shock-Induced Vm
Changes |
256 |
|
|
The Role of Microscopic Tissue
Structure in the Shock Effects: Experiments in Cell Cultures |
258 |
|
|
The Role of Cell Boundaries in
Shock Effects |
259 |
|
|
The Role of Intercellular Clefts
in the Shock Effects |
261 |
|
|
Shock-Induced
Δ Vm in Cell Strands |
263 |
|
|
Measurements of Intramural
Shock-Induced Δ Vm in Wedge Preparations |
270 |
|
|
Comparison Between Microscopic
and Macroscopic a Vm Measurements |
275 |
|
|
Conclusion |
277 |
|
|
References |
277 |
|
4.3 |
Virtual Electrode Theory of Pacing |
283 |
|
|
Introduction |
283 |
|
|
Virtual Electrodes during Unipolar
Stimulation of Cardiac Tissue |
284 |
|
|
Anode and Cathode Make and Break
Excitation |
290 |
|
|
Strength-Interval Curves |
293 |
|
|
Quatrefoil Reentry |
296 |
|
|
Defibrillation |
301 |
|
|
The No-Response Phenomenon and
the Upper Limit of Vulnerability |
306 |
|
|
Influence of Physical Electrodes
During a Shock |
306 |
|
|
The Effect of Fiber Curvature on
Stimulation of Cardiac Tissue |
307 |
|
|
Heterogeneities |
310 |
|
|
Averaging Over Depth During
Optical Mapping |
311 |
|
|
Boundary Conditions and the Bidomain Model |
312 |
|
|
The Magnetic Field Produced by
Cardiac Tissue |
313 |
|
|
Conclusion |
315 |
|
|
Acknowledgments |
316 |
|
|
References |
317 |
|
4.4 |
The Virtual Electrode Hypothesis of Defibrillation |
331 |
|
|
Introduction |
331 |
|
|
Historical Overview of Defibrillation Therapy |
331 |
|
|
Bidomain Model |
332 |
|
|
Fluorescent Optical Mapping |
333 |
|
|
Virtual Electrodes
and the Activating Function |
334 |
|
|
Mechanisms of Defibrillation |
335 |
|
|
Theories of Defibrillation |
335 |
|
|
Virtual Electrode
Hypothesis of Defibrillation: The Role of Deexcitation and Reexcitation |
336 |
|
|
Virtual Electrode-Induced
Phase Singularity Mechanism |
337 |
|
|
Chirality of Shock-Induced
Reentry Predicted by VEP Not the Repolarization Gradient |
340 |
|
|
Shock-Induced
VEP as a Mechanism for Defibrillation Failure |
343 |
|
|
The Role of Electroporation |
344 |
|
|
Clinical Implications of the
Virtual Electrode Hypothesis of Defibrillation |
344 |
|
|
The Role of Virtual Electrodes
and Shock Polarity |
344 |
|
|
Waveform Optimization |
345 |
|
|
Toward Low-Energy Defibrillation |
347 |
|
|
Conclusion |
351 |
|
|
References |
351 |
|
4.5 |
Simultaneous Optical and Electrical Recordings |
357 |
|
|
Introduction to Electrooptical
Measurements |
357 |
|
|
ITO Properties |
358 |
|
|
Ratiometric Optical Mapping |
359 |
|
|
Rule of the Second Spatial
Derivative of the Extracellular
Potential in Field Stimulation |
360 |
|
|
Stimulatory Effects of a Spatial
Variation of Extracellular
Conductance in the Electric Field |
364 |
|
|
Effect of Unipolar Stimulation in the Tissue
Under the Electrode |
365 |
|
|
Electrooptical Mapping of Cardiac Excitation |
368 |
|
|
Method of Electrooptical Mapping |
369 |
|
|
Electrooptical Mapping of Epicardially Paced Beats and Sinus
Beats |
370 |
|
|
Electrooptical Mapping of Fibrillation |
375 |
|
|
Conclusion |
378 |
|
|
References |
378 |
|
4.6 |
Optical Mapping of Multisite Ventricular Fibrillation
Synchronization |
381 |
|
|
Pacing to Terminate Ventricular
Fibrillation |
382 |
|
|
New Opportunities in Improving
Ventricular Defibrillation |
382 |
|
|
Optical Mapping of Multisite
Synchronization of Ventricular Fibrillation |
383 |
|
|
Optical Recording-Guided Pacing
to Create Functional Block during VF |
387 |
|
|
Improvement of Defibrillation
Efficacy with Synchronized Multisite
Pacing |
389 |
|
|
Conclusion |
393 |
|
|
References |
393 |
|
PART V |
METHODOLOGY |
|
|
5.1 |
The Bidomain Model of Cardiac Tissue: From Microscale to Macroscale |
401 |
|
|
Introduction |
401 |
|
|
Microscopic Modeling Cardiac
Tissue |
403 |
|
|
Macroscopic Modeling Cardiac
Tissue |
404 |
|
|
Homogenization |
406 |
|
|
Bidomain Model of Cardiac Tissue |
410 |
|
|
Bidomain Properties at the Tissue Level |
411 |
|
|
Bidomain Properties at the Heart Level |
410 |
|
|
Conclusion |
417 |
|
|
References |
418 |
|
5.2 |
Multielectrode Mapping of the Heart |
423 |
|
|
Introduction |
423 |
|
|
Methods |
421 |
|
|
Determining Activation Time |
425 |
|
|
Generating Contours |
432 |
|
|
Conclusion |
437 |
|
|
References |
438 |
|
5.3 |
The Role of Electroporation |
441 |
|
|
Role of Electroporation in Defibrillation |
441 |
|
|
Contribution of Electroporation
to Optically Recorded Cellular Responses |
446 |
|
|
Electroporation Assessment by Membrane
Impermeable Dye Diffusion |
448 |
|
|
Role of Electroporation in Pacing |
451 |
|
|
Irreversible Electroporation in Cardiac Surgery |
451 |
|
|
Conclusion |
451 |
|
|
References |
452 |
|
PART VI |
IMPLICATIONS FOR
IMPLANTABLE DEVICES |
|
|
6.1 |
Lessons for the Clinical Implant |
459 |
|
|
Electrical Parameters of
Defibrillation Waveforms |
459 |
|
|
Parameters that Influence Defibrillation |
459 |
|
|
Parameters that Influence ICD Design |
459 |
|
|
Principles of Capacitive
Discharge Waveforms |
461 |
|
|
Truncation |
461 |
|
|
Stored versus Delivered Energy |
463 |
|
|
Optimizing Waveforms with the RC
Network Model |
464 |
|
|
Minimizing Shock Energy without
Electronic Constraints |
465 |
|
|
The Predicted Optimal Monophasic Shock |
465 |
|
|
The Predicted Optimal Biphasic
Shock |
468 |
|
|
Optimizing Capacitive Discharge
Waveforms |
468 |
|
|
Optimizing Duration: Monophasic Shock and First Phase of
Biphasic Shock with a Fixed Capacitance |
468 |
|
|
Optimizing Capacitance |
471 |
|
|
Optimizing Phase Two of the Biphasic
Waveform |
472 |
|
|
Truncation by Duration versus Truncation
by Tilt |
473 |
|
|
Waveform Polarity |
478 |
|
|
Waveforms in Commercially
Available ICDs |
480 |
|
|
Other Considerations in
Optimizing Waveforms |
483 |
|
|
The Misunderstood Superior Vena
Cava Coil |
484 |
|
|
Conclusion |
485 |
|
|
References |
486 |
|
6.2 |
Resonance and Feedback Strategies for Low-Voltage
Defibrillation |
493 |
|
|
Introduction |
493 |
|
|
Localized Stimulation: Induced
Drift of Spiral Waves |
493 |
|
|
Delocalized Stimulation:
Resonant Drift of Spiral Waves |
495 |
|
|
Feedback-Controlled Resonant
Drift |
498 |
|
|
Three-Dimensional Aspects |
501 |
|
|
Pinning and Unpinning |
502 |
|
|
“Black-Box” Approaches |
507 |
|
|
Conclusion |
507 |
|
|
Acknowledgments |
508 |
|
|
References |
508 |
|
6.3 |
Pacing Control of Local Cardiac Dynamics |
511 |
|
|
Introduction |
511 |
|
|
Chaos Control |
511 |
|
|
Alternans Control |
515 |
|
|
APD Alternans |
515 |
|
|
Conduction Velocity Alternans |
520 |
|
|
References |
521 |
|
6.4 |
Advanced Methods for Assessing the Stability and
Control of Alternans |
525 |
|
|
Introduction |
525 |
|
|
What is an Eigenmode? |
528 |
|
|
Characterization and Control of Alterants in
Isolated Cardiac Myocytes |
531 |
|
|
Application of the Eigenmode Method |
531 |
|
|
The Ion Channel Mechanism
Underlying Alternans |
534 |
|
|
Development and Testing of a Control
Algorithm |
537 |
|
|
Characterization and Control of
Spiral Wave Instabilities |
540 |
|
|
Nature of Spiral Wave Instabilities |
540 |
|
|
Elimination of Alternans in a Rotating Spiral Wave |
542 |
|
|
Summary and Implications for
Treatment of Cardiac Arrhythmias |
543 |
|
|
Appendix: Mathematical Details |
544 |
|
|
References |
547 |
|
6.5 |
The Future of the Implantable Defibrillator |
551 |
|
|
Sensing and Detection |
551 |
|
|
Reduction of Ventricular Oversensing |
551 |
|
|
Active SVT-VT Discrimination |
552 |
|
|
Hemodynamic Sensors for ICDs |
552 |
|
|
Implant Testing |
553 |
|
|
Vulnerability Testing |
555 |
|
|
State of the Art |
557 |
|
|
After the Implant |
559 |
|
|
Novel Waveform Strategies |
559 |
|
|
Defibrillation Threshold Reduction |
559 |
|
|
Cardioversion Pain Reduction |
561 |
|
|
Medium Voltage Therapy |
562 |
|
|
Novel Packaging Strategies |
562 |
|
|
Subcutaneous ICDs |
562 |
|
|
Percutaneous, Fully Transvenous ICD |
563 |
|
|
Conclusion |
563 |
|
|
References |
563 |
|
6.6 |
Lessons Learned from Implantable Cardioverter-Defibrillators
Recordings |
571 |
|
|
Introduction |
571 |
|
|
ICD Electrograms |
572 |
|
|
Interpretation of ICD Recordings |
573 |
|
|
Lessons Learned from ICD
Treatment of Ventricular Tachyarrhythmias |
575 |
|
|
Incidence of Ventricular Tachyarrhythmias |
575 |
|
|
Therapy Efficacy and Failure Modes |
578 |
|
|
Therapy Efficacy: Defibrillation |
579 |
|
|
Therapy Efficacy: Cardioversion |
581 |
|
|
Therapy Efficacy: Antitachycardia Pacing |
583 |
|
|
Investigating the Causes of Tachyarrhythmia |
586 |
|
|
Lessons Learned from
Inappropriately Treated ICD Episodes |
591 |
|
|
Inappropriate Detection Due to Oversensing |
591 |
|
|
Inappropriate Detection and Therapy Due to Nonsustained
VT/VF |
593 |
|
|
Inappropriate Detection Due to Supraventricular
Tachycardia |
593 |
|
|
Inappropriate ICD Therapies and Changing
Patient Population |
597 |
|
|
Lessons Learned from
Appropriately Treated AT/AF Episodes |
597 |
|
|
Atrial Tachyarrhythmia Detection and
Termination Accuracy |
597 |
|
|
Efficacy of Device-Based Therapies for
AT/AF |
600 |
|
|
AT/AF Therapy Efficacy: Impact
of Early Recurrence of a trial Fibrillation |
600 |
|
|
Atrial ATP Therapy Efficacy |
600 |
|
|
Atrial Defibrillation Shock Efficacy |
603 |
|
|
Conclusion |
604 |
|
|
References |
604 |
|
|
Index |
615 |
|
|
|
|