Bidomain Model of Defibrillation

  • Natalia Trayanova
  • Gernot Plank

Defibrillation of the heart by high-intensity electric shocks is currently the only reliable procedure for termination of ventricular fibrillation. Despite the critical role that defibrillation therapy plays in saving human life, elucidating the mechanisms by which electric shocks halt life-threatening arrhythmias has been a long and arduous process. Uncovering how electric current delivered to the heart to terminate lethal arrhythmias traverses myocardial structures and interacts with the wavefronts of fibrillation has been enormously challenging. Of particular importance has been obtaining insight into the mechanisms by which the shock fails since reinitiation of fibrillation is related not only to the effect of the shock on the electrical state of the myocardium, but also to the intrinsic properties of the tissue that lead to destabilization of postshock activations and their degradation into electric turbulence. The complexity of the relationships and dependencies to be teased out and dissected in this quest has been staggering.

Although over the years defibrillation devices have become smaller and their batteries longer lasting, defibrillation remains a traumatic experience, often resulting in myocardial dysfunction and damage. Furthermore, recent meta-analysis of industrial reports concluded that thousands of patients have been affected by high-voltage component implantable cardioverter-defibrillator (ICD) malfunctions, causing severe psychological trauma.1 A significant reduction in shock energy can only be achieved by full appreciation of the mechanisms by which a shock interacts with the heart and then exploiting them to devise novel therapeutic approaches. Thus, comprehensive mechanistic insight into defibrillation remains a major scientific frontier. This chapter examines an important tool in the quest to understand the defibrillation mechanisms, the three-dimensional (3D) bidomain model of defibrillation.


Right Ventricle Spiral Wave Virtual Cathode Phase Singularity Coupling Interval 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Natalia Trayanova
    • 1
  • Gernot Plank
    • 1
    • 2
  1. 1.Department of Biomedical EngineeringInstitute for Computational Medicine, Johns Hopkins UniversityUSA
  2. 2.Institute of BiophysicsMedical University GrazAustria

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