Verfügbarkeit: Cardiac bioelectric therapy

Cardiac bioelectric therapy: mechanisms and practical implications

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Format:	Buch
Sprache:	English
Veröffentlicht:	New York, NY Springer 2009
Schlagworte:	Arrhythmias, Cardiac > therapy Bioelectric Energy Sources Cardiac Pacing, Artificial Cardiac pacing Cardiovascular instruments, Implanted Defibrillators, Implantable Electric Countershock Electrophysiology Electrotherapeutics Heart > Diseases > Treatment Heart > Electric properties Pacemaker, Artificial
Online-Zugang:	Inhaltsverzeichnis
Beschreibung:	XXII, 634 S. Ill., graph. Darst.
ISBN:	0387794026 9780387794020

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MARC


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245	1	0	\|a Cardiac bioelectric therapy \|b mechanisms and practical implications \|c ed. by Igor R. Efimov ...
264		1	\|a New York, NY \|b Springer \|c 2009
300			\|a XXII, 634 S. \|b Ill., graph. Darst.
336			\|b txt \|2 rdacontent
337			\|b n \|2 rdamedia
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650		4	\|a Arrhythmias, Cardiac \|x therapy
650		4	\|a Bioelectric Energy Sources
650		4	\|a Cardiac Pacing, Artificial
650		4	\|a Cardiac pacing
650		4	\|a Cardiovascular instruments, Implanted
650		4	\|a Defibrillators, Implantable
650		4	\|a Electric Countershock
650		4	\|a Electrophysiology
650		4	\|a Electrotherapeutics
650		4	\|a Heart \|x Diseases \|x Treatment
650		4	\|a Heart \|x Electric properties
650		4	\|a Pacemaker, Artificial
700	1		\|a Efimov, Igor R. \|e Sonstige \|0 (DE-588)13767015X \|4 oth
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Datensatz im Suchindex

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adam_text	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 Defibrillatore ...................................................................................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: Prom Russia and the Soviet Block ................................................................26 Defibrillation: AC to DC, in America and Beyond ..............................................................30 Conclusion .....................................................................................................................................35 References ......................................................................................................................................38 VI Contents 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 Мое: 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 Contents vii 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 ULVandLLV ......................................................................................................................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 ................................................................................................................................ Ill 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 Resealing Phase .........................................................................................................149 Effects of Shock Strength .................................................................................................149 Limitations ..................................................................................................................................151 viii Contents 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 Eŕfecťs Role in Tissue: Fact or Fantasy .................................................241 Contents ix Effect of Electric Fields on Intracellular Calcium ..............................................................243 Q j Measurement of Intracellular Ca Transients Using Fluorescent Probes .............................................................................................................244 Effect of Field Stimulation on Intracellular Ca * Transients at Rest ..................244 Effect of Field Stimulation on Intracellular Ca Transients During Plateau ....................................................................................................................248 Implications of Field-Induced Ca 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 AVm in Cell Strands ...........................................................................263 Measurements of Intramural Shock-Induced Δ Ущ in Wedge Preparations ..................................................................................................................270 Comparison between Microscopic and Macroscopic AVm 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 Contents 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 Role of the Second Spatial Derivative of the Extracellular Potential in Field Stimulation ...................................................................................................................360 Stimulatory Effects of a Spatial Variation of Extracellular Conductance in an 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 Contents Improvement of Defibrillation Efficacy with Synchronized Multisite Pacing ...............389 Conclusion ...................................................................................................................................393 References ....................................................................................................................................393 Part V Methodology 5.1 The Bidomain Model of Cardiac Tissue: Erom 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 ...............................................................................416 Conclusion ...................................................................................................................................417 References ....................................................................................................................................418 5.2 Multielectrode Mapping of the Heart 423 Introduction ................................................................................................................................423 Methods .......................................................................................................................................424 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 Impiantatile 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 Contents 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 Deflbrillation 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 Alternane Control ......................................................................................................................515 APD Alternane ...................................................................................................................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 Contents xiii Characterization and Control of Alterans 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 Deñbrillator 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 Tachyarrhythrma ..............................................................586 xiv Contents 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 АТ /AF Episodes .....................................597 Atrial Tachyarrhythmia Detection and Termination Accuracy ...............................597 Efficacy of Device-Based Therapies for АТ /AF .......................................................... 600 АТ /AF Therapy Efficacy: Impact of Early Recurrence of Atrial Fibrillation ......600 Atrial ATP Therapy Efficacy ...........................................................................................600 Atrial Defibrillation Shock Efficacy ................................................................................603 Conclusion ...................................................................................................................................604 References ....................................................................................................................................604 Index 615
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publisher	Springer
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spelling	Cardiac bioelectric therapy mechanisms and practical implications ed. by Igor R. Efimov ... New York, NY Springer 2009 XXII, 634 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Arrhythmias, Cardiac therapy Bioelectric Energy Sources Cardiac Pacing, Artificial Cardiac pacing Cardiovascular instruments, Implanted Defibrillators, Implantable Electric Countershock Electrophysiology Electrotherapeutics Heart Diseases Treatment Heart Electric properties Pacemaker, Artificial Efimov, Igor R. Sonstige (DE-588)13767015X oth Erscheint auch als Online-Ausgabe 978-0-387-79403-7 Digitalisierung UB Regensburg application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017183607&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis
spellingShingle	Cardiac bioelectric therapy mechanisms and practical implications Arrhythmias, Cardiac therapy Bioelectric Energy Sources Cardiac Pacing, Artificial Cardiac pacing Cardiovascular instruments, Implanted Defibrillators, Implantable Electric Countershock Electrophysiology Electrotherapeutics Heart Diseases Treatment Heart Electric properties Pacemaker, Artificial
title	Cardiac bioelectric therapy mechanisms and practical implications
title_auth	Cardiac bioelectric therapy mechanisms and practical implications
title_exact_search	Cardiac bioelectric therapy mechanisms and practical implications
title_full	Cardiac bioelectric therapy mechanisms and practical implications ed. by Igor R. Efimov ...
title_fullStr	Cardiac bioelectric therapy mechanisms and practical implications ed. by Igor R. Efimov ...
title_full_unstemmed	Cardiac bioelectric therapy mechanisms and practical implications ed. by Igor R. Efimov ...
title_short	Cardiac bioelectric therapy
title_sort	cardiac bioelectric therapy mechanisms and practical implications
title_sub	mechanisms and practical implications
topic	Arrhythmias, Cardiac therapy Bioelectric Energy Sources Cardiac Pacing, Artificial Cardiac pacing Cardiovascular instruments, Implanted Defibrillators, Implantable Electric Countershock Electrophysiology Electrotherapeutics Heart Diseases Treatment Heart Electric properties Pacemaker, Artificial
topic_facet	Arrhythmias, Cardiac therapy Bioelectric Energy Sources Cardiac Pacing, Artificial Cardiac pacing Cardiovascular instruments, Implanted Defibrillators, Implantable Electric Countershock Electrophysiology Electrotherapeutics Heart Diseases Treatment Heart Electric properties Pacemaker, Artificial
url	http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017183607&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
work_keys_str_mv	AT efimovigorr cardiacbioelectrictherapymechanismsandpracticalimplications

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