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Evolution of activation patterns during long-duration ventricular fibrillation in pigs

机译:猪长期心室纤颤期间激活模式的演变

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摘要

Quantitative analysis has demonstrated five temporal stages of activation during the first 10 min of ventricular fibrillation (VF) in dogs. To determine whether these stages exist in another species, we applied the same analysis to the first 10 min of VF recorded in vivo from two 504-electrode arrays, one each on left anterior and posterior ventricular epicardium in six anesthetized pigs. The following descriptors were continuously quantified: 1) number of wavefronts, 2) wavefront fractionations, 3) wavefront collisions, 4) repeatability, 5) multiplicity index, 6) wavefront conduction velocity, 7) activation rate, 8) mean area activated by the wavefronts, 9) negative peak rate of voltage change, 10) incidence of breakthrough/foci, 11) incidence of block, and 12) incidence of reentry. Cluster analysis of these descriptors divided VF into four stages (stages i-iv). The values of most descriptors increased during stage i (1–22 s after VF induction), changed quickly to values indicating greater organization during stage ii (23–39 s), decreased steadily during stage iii (40–187 s), and remained relatively unchanged during stage iv (188–600 s). The epicardium still activated during stage iv instead of becoming silent as in dogs. In conclusion, during the first 10 min, VF activation can be divided into four stages in pigs instead of five stages as in dogs. Following a 16-s period during the first minute of VF when activation became more organized, all parameters exhibited progressive decreased organization. Further studies are warranted to determine whether these changes, particularly the increased organization of stage ii, have clinical consequences, such as alteration in defibrillation efficacy.
机译:定量分析表明,犬心室颤动(VF)的前10分钟内激活的五个时间阶段。为了确定这些阶段是否存在于另一个物种中,我们对六只麻醉猪的两个504电极阵列(在左前和后心室心外膜各一个)在体内记录的VF的前10分钟进行了相同的分析。连续地量化以下描述符:1)波前数量,2)波前分馏,3)波前碰撞,4)可重复性,5)多重指数,6)波前传导速度,7)激活速率,8)被激活的平均面积波阵面; 9)电压变化的负峰值速率; 10)突破/焦点发生率; 11)阻塞发生率; 12)再入事件。这些描述符的聚类分析将VF分为四个阶段(第i-iv阶段)。大多数描述符的值在第i阶段(VF诱导后1–22 s)增加,迅速变为表示第ii阶段(23–39 s)组织更大的值,在iii阶段(40–187 s)稳定下降,并保持不变在第四阶段(188-600 s)相对没有变化。心外膜在第四阶段期间仍处于激活状态,而不是像狗一样变得沉默。总之,在最初的10分钟内,猪的VF激活可分为四个阶段,而不是狗的五个阶段。在VF的第一分钟内经过16秒的时间后,激活变得更加有条理,所有参数均显示出逐渐减少的组织。因此,有必要进行进一步的研究以确定这些变化,特别是ii期的组织增加是否具有临床后果,例如除颤功效的改变。

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