Key result
In a stable canine model, significant spatial variability (average difference 13%) and minimal temporal variability in interactivation intervals indicate that a single spiral wave cannot generate ventricular fibrillation.
The onset of ventricular fibrillation is a multistage process where spiral-wave breakdown is a crucial step, rather than being generated by a single spiral wave.
Supports multistage VF onset in canines; leaves open translation to human arrhythmia mechanisms.
Ventricular fibrillation is the major cause of sudden cardiac death, the leading cause of death in the industrialized world; however, the mechanisms for its onset are not well understood. To further understand the dynamics of fibrillation at and near its onset, we compared spatial and temporal variability of mean interactivation intervals in a stable canine model for ventricular fibrillation. Temporal variability was very small, suggesting that the relevant physiological parameters remained constant during our experiments. Spatial variability was usually significantly larger and appeared incompatible with the dynamics of a single, meandering spiral wave. This confirmed recent results that a single spiral wave cannot generate ventricular fibrillation. Thus the onset of fibrillation is a multistage process, with spiral-wave breakdown providing a crucial step in the quasi-periodic route to fibrillation.
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Evans et al. (1998) studied Ventricular fibrillation (n=4). Induced ventricular fibrillation vs. Temporal variability (within-site) was evaluated on Spatial variability of interactivation intervals (p=<0.001). In a stable canine model, significant spatial variability (average difference 13%) and minimal temporal variability in interactivation intervals indicate that a single spiral wave cannot generate ventricular fibrillation.
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