Cardiac defibrillation and the role of mechanoelectric feedback in
postshock arrhythmogenesis.
Ann. N. Y. Acad. Sci., (October 2006)DOI: 10.1196/annals.1380.024
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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