Key result
This review outlines the mechanisms of ventricular defibrillation across multiple levels, from shock strength and electrical fields to cellular action potentials and subcellular ion channel responses.
This review provides a comprehensive overview of the multi-level mechanisms underlying ventricular defibrillation, from macroscopic electrical fields to subcellular ion channel responses.
May refine device waveform optimization; leaves open clinical validation of subcellular targets.
The mechanism of ventricular defibrillation can be considered at many different levels. The highest level is considered at strength of the shock given through the defibrillation electrodes. At the next level, the mechanism of defibrillation can be examined in terms of the electrical field that the shock produces throughout the ventricles. Other levels include the effects this electric field has on the activation sequences and on the cellular action potentials that either initiate or inhibit the early sites of activation following the shock. Yet another level considers the mechanism by which the shock field initiates new action potentials or prolongs the action potential by changing the transmembrane potential during the shock. Finally, the subcellular level is considered, which involves the response of the individual ion channels to the shock. This review gives a brief overview of some salient features of defibrillation at each of these mechanistic levels.
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WALGOTT et al. (1997) conducted a review in Ventricular fibrillation. Ventricular defibrillation was evaluated. This review outlines the mechanisms of ventricular defibrillation across multiple levels, from shock strength and electrical fields to cellular action potentials and subcellular ion channel responses.
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