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Estimating the Ventricular Fibrillation Threshold

  • Chapter
Theory of Heart

Part of the book series: Institute for Nonlinear Science ((INLS))

Abstract

Implicit in the basic principles of reasonably uniform excitable media is a vortexlike mode of self-excitation. In heart muscle this would be a rotating action potential and it has in fact been found in both two- and three-dimensional settings. It rotates in 120 msec and has a core diameter of \(\frac{2}{3}\) cm or less, conforming to rough estimates based on oversim- plified physics. Similar estimates indicate that the point-stimulus threshold should be about 4 mA/cm2, based on observed thresholds of total current and a theoretical estimate of the maximum wavefront curvature compatible with sustained propagation. The vortex diameter together with the stimulation threshold can be used to derive the electrical threshold for nucleation by a stable vortex pair: this 16 mA estimate also compares favorably with observations of the electrical threshold for instigation of fibrillation. Electrical defibrillation should require local potential gradients of about 6 V/cm or current densities near 20 mA/cm2, also roughly as observed. Quantitative derivation of these thresholds became feasible only after the pertinent electrophysiology was simplified beyond the comfort level of competent theorists, but this is sometimes how a new starting point is secured for eventual refinement to a believable theory.

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Authors and Affiliations

  1. Department of Ecology and Evolutionary Biology, University of Arizona, 85721, Tucson, Arizona, USA

    A. T. Winfree

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  1. Department of Physiology, McGill University, Montreal, Quebec, H3G 1Y6, Canada

    Leon Glass

  2. Department of Engineering Science, University of Auckland, Auckland, New Zealand

    Peter Hunter

  3. Department of Applied Mechanics and Engineering Science—Bioengineering, University of California, San Diego, La Jolla, CA, 92093, USA

    Andrew McCulloch

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Winfree, A.T. (1991). Estimating the Ventricular Fibrillation Threshold. In: Glass, L., Hunter, P., McCulloch, A. (eds) Theory of Heart. Institute for Nonlinear Science. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3118-9_19

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  • DOI: https://doi.org/10.1007/978-1-4612-3118-9_19

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