04343nas a2200433 4500008004100000022001400041245015100055210006900206260001600275490000700291520297600298653001003274653000903284653001903293653002403312653001103336653001503347653001103362653000903373653001603382653002803398653004603426653002803472100001803500700002303518700002103541700002203562700001803584700001403602700001903616700001703635700002603652700002403678700002103702700002303723700001903746700002303765856012103788 2025 eng d a2050-084X00aThe effect of transcutaneous auricular vagus nerve stimulation on cardiovascular function in subarachnoid hemorrhage patients: A randomized trial.0 aeffect of transcutaneous auricular vagus nerve stimulation on ca c2025 Jan 090 v133 a

BACKGROUND: Subarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia. Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients. However, the effects of taVNS on cardiovascular dynamics in critically ill patients, like those with SAH, have not yet been investigated. Given the association between cardiac complications and elevated risk of poor clinical outcomes after SAH, it is essential to characterize the cardiovascular effects of taVNS to ensure this approach is safe in this fragile population. Therefore, this study assessed the impact of both acute and repetitive taVNS on cardiovascular function.

METHODS: In this randomized clinical trial, 24 SAH patients were assigned to either a taVNS treatment or a sham treatment group. During their stay in the intensive care unit, we monitored patient electrocardiogram readings and vital signs. We compared long-term changes in heart rate, heart rate variability (HRV), QT interval, and blood pressure between the two groups. Additionally, we assessed the effects of acute taVNS by comparing cardiovascular metrics before, during, and after the intervention. We also explored acute cardiovascular biomarkers in patients exhibiting clinical improvement.

RESULTS: We found that repetitive taVNS did not significantly alter heart rate, QT interval, blood pressure, or intracranial pressure (ICP). However, repetitive taVNS increased overall HRV and parasympathetic activity compared to the sham treatment. The increase in parasympathetic activity was most pronounced from 2 to 4 days after initial treatment (Cohen's = 0.50). Acutely, taVNS increased heart rate, blood pressure, and peripheral perfusion index without affecting the corrected QT interval, ICP, or HRV. The acute post-treatment elevation in heart rate was more pronounced in patients who experienced a decrease of more than one point in their modified Rankin Score at the time of discharge.

CONCLUSIONS: Our study found that taVNS treatment did not induce adverse cardiovascular effects, such as bradycardia or QT prolongation, supporting its development as a safe immunomodulatory treatment approach for SAH patients. The observed acute increase in heart rate after taVNS treatment may serve as a biomarker for SAH patients who could derive greater benefit from this treatment.

FUNDING: The American Association of Neurological Surgeons (ALH), The Aneurysm and AVM Foundation (ALH), The National Institutes of Health R01-EB026439, P41-EB018783, U24-NS109103, R21-NS128307 (ECL, PB), McDonnell Center for Systems Neuroscience (ECL, PB), and Fondazione Neurone (PB).

CLINICAL TRIAL NUMBER: NCT04557618.

10aAdult10aAged10aBlood Pressure10aElectrocardiography10aFemale10aHeart Rate10aHumans10aMale10aMiddle Aged10aSubarachnoid Hemorrhage10aTranscutaneous Electric Nerve Stimulation10aVagus Nerve Stimulation1 aTan, Gansheng1 aHuguenard, Anna, L1 aDonovan, Kara, M1 aDemarest, Phillip1 aLiu, Xiaoxuan1 aLi, Ziwei1 aAdamek, Markus1 aLavine, Kory1 aVellimana, Ananthv, K1 aKummer, Terrance, T1 aOsbun, Joshua, W1 aZipfel, Gregory, J1 aBrunner, Peter1 aLeuthardt, Eric, C uhttps://neurotechcenter.org/publications/2025/effect-transcutaneous-auricular-vagus-nerve-stimulation-cardiovascular07936nas a2200361 4500008004100000022001400041245009600055210006900151260001200220300001100232490000800243520694900251653001507200653001007215653002807225653002007253653001007273653002507283653002407308653001107332653001107343653000907354653001607363653001907379653001607398100001607414700001907430700002207449700001707471700001707488700002107505856004807526 2010 eng d a1091-649000aCortical activity during motor execution, motor imagery, and imagery-based online feedback.0 aCortical activity during motor execution motor imagery and image c03/2010 a4430-50 v1073 a

Imagery of motor movement plays an important role in learning of complex motor skills, from learning to serve in tennis to perfecting a pirouette in ballet. What and where are the neural substrates that underlie motor imagery-based learning? We measured electrocorticographic cortical surface potentials in eight human subjects during overt action and kinesthetic imagery of the same movement, focusing on power in "high frequency" (76-100 Hz) and "low frequency" (8-32 Hz) ranges. We quantitatively establish that the spatial distribution of local neuronal population activity during motor imagery mimics the spatial distribution of activity during actual motor movement. By comparing responses to electrocortical stimulation with imagery-induced cortical surface activity, we demonstrate the role of primary motor areas in movement imagery. The magnitude of imagery-induced cortical activity change was approximately 25% of that associated with actual movement. However, when subjects learned to use this imagery to control a computer cursor in a simple feedback task, the imagery-induced activity change was significantly augmented, even exceeding that of overt movement.

10aAdolescent10aAdult10aBiofeedback, Psychology10aCerebral Cortex10aChild10aElectric Stimulation10aElectrocardiography10aFemale10aHumans10aMale10aMiddle Aged10aMotor Activity10aYoung Adult1 aMiller, K J1 aSchalk, Gerwin1 aFetz, Eberhard, E1 aNijs, Marcel1 aOjemann, J G1 aRao, Rajesh, P N uhttp://www.ncbi.nlm.nih.gov/pubmed/2016008401979nas a2200373 4500008004100000022001400041245011800055210006900173260000900242300001100251490000900262520077500271653001501046653002401061653003001085653001101115653000901126653003501135653003201170653002301202653003101225653003201256653002801288653001801316100002001334700001701354700001901371700002001390700002401410700001701434700001701451700002101468856011601489 2009 eng d a1557-170X00aDetection of spontaneous class-specific visual stimuli with high temporal accuracy in human electrocorticography.0 aDetection of spontaneous classspecific visual stimuli with high  c2009 a6465-80 v20093 aMost brain-computer interface classification experiments from electrical potential recordings have been focused on the identification of classes of stimuli or behavior where the timing of experimental parameters is known or pre-designated. Real world experience, however, is spontaneous, and to this end we describe an experiment predicting the occurrence, timing, and types of visual stimuli perceived by a human subject from electrocorticographic recordings. All 300 of 300 presented stimuli were correctly detected, with a temporal precision of order 20 ms. The type of stimulus (face/house) was correctly identified in 95% of these cases. There were approximately 20 false alarm events, corresponding to a late 2nd neuronal response to a previously identified event.10aAlgorithms10aElectrocardiography10aEvoked Potentials, Visual10aHumans10aMale10aPattern Recognition, Automated10aPattern Recognition, Visual10aPhotic Stimulation10aReproducibility of Results10aSensitivity and Specificity10aUser-Computer Interface10aVisual Cortex1 aMiller, John, W1 aHermes, Dora1 aSchalk, Gerwin1 aRamsey, Nick, F1 aJagadeesh, Bharathi1 aNijs, Marcel1 aOjemann, J G1 aRao, Rajesh, P N uhttps://neurotechcenter.org/publications/2009/detection-spontaneous-class-specific-visual-stimuli-high-temporal01322nas a2200265 4500008004100000022001400041245005600055210005400111260000900165300001300174490000900187520048800196653001500684653001000699653002400709653002100733653003100754653001900785653003100804653003200835653004100867653002800908100001900936856010100955 2009 eng d a1557-170X00aEffective brain-computer interfacing using BCI2000.0 aEffective braincomputer interfacing using BCI2000 c2009 a5498-5010 v20093 aTo facilitate research and development in Brain-Computer Interface (BCI) research, we have been developing a general-purpose BCI system, called BCI2000, over the past nine years. This system has enjoyed a growing adoption in BCI and related areas and has been the basis for some of the most impressive studies reported to date. This paper gives an update on the status of this project by describing the principles of the BCI2000 system, its benefits, and impact on the field to date.10aAlgorithms10aBrain10aElectrocardiography10aEquipment Design10aEquipment Failure Analysis10aRehabilitation10aReproducibility of Results10aSensitivity and Specificity10aSignal Processing, Computer-Assisted10aUser-Computer Interface1 aSchalk, Gerwin uhttps://neurotechcenter.org/publications/2009/effective-brain-computer-interfacing-using-bci200005137nas a2200373 4500008004100000022001400041245007500055210006900130260001200199300001000211490000800221520406800229653001004297653001504307653001004322653001804332653002404350653002704374653001104401653000904412653002404421653002404445653001904469653003604488653004104524653002404565653002804589100001904617700001904636700002404655700001504679700002104694856004804715 2008 eng d a0165-027000aBrain-computer interfaces (BCIs): Detection Instead of Classification.0 aBraincomputer interfaces BCIs Detection Instead of Classificatio c01/2008 a51-620 v1673 a

Many studies over the past two decades have shown that people can use brain signals to convey their intent to a computer through brain-computer interfaces (BCIs). These devices operate by recording signals from the brain and translating these signals into device commands. They can be used by people who are severely paralyzed to communicate without any use of muscle activity. One of the major impediments in translating this novel technology into clinical applications is the current requirement for preliminary analyses to identify the brain signal features best suited for communication. This paper introduces and validates signal detection, which does not require such analysis procedures, as a new concept in BCI signal processing. This detection concept is realized with Gaussian mixture models (GMMs) that are used to model resting brain activity so that any change in relevant brain signals can be detected. It is implemented in a package called SIGFRIED (SIGnal modeling For Real-time Identification and Event Detection). The results indicate that SIGFRIED produces results that are within the range of those achieved using a common analysis strategy that requires preliminary identification of signal features. They indicate that such laborious analysis procedures could be replaced by merely recording brain signals during rest. In summary, this paper demonstrates how SIGFRIED could be used to overcome one of the present impediments to translation of laboratory BCI demonstrations into clinically practical applications.

10aAdult10aAlgorithms10aBrain10aBrain Mapping10aElectrocardiography10aElectroencephalography10aHumans10aMale10aMan-Machine Systems10aNormal Distribution10aOnline Systems10aSignal Detection, Psychological10aSignal Processing, Computer-Assisted10aSoftware Validation10aUser-Computer Interface1 aSchalk, Gerwin1 aBrunner, Peter1 aGerhardt, Lester, A1 aBischof, H1 aWolpaw, Jonathan uhttp://www.ncbi.nlm.nih.gov/pubmed/1792013402352nas a2200445 4500008004100000245007200041210006900113260003300182520109300215653001501308653001001323653001501333653003401348653002001382653001801402653002401420653001501444653002701459653002801486653001301514653001101527653001401538653001401552653001101566653000901577653001601586653001701602653002201619653002401641653003401665653001101699653002801710100001901738700002101757700001901778700001701797700002001814700002401834856004801858 2008 eng d00aThree cases of feature correlation in an electrocorticographic BCI.0 aThree cases of feature correlation in an electrocorticographic B aVancouver, BCbIEEEc08/20083 aThree human subjects participated in a closed-loop brain computer interface cursor control experiment mediated by implanted subdural electrocorticographic arrays. The paradigm consisted of several stages: baseline recording, hand and tongue motor tasks as the basis for feature selection, two closed-loop one-dimensional feedback experiments with each of these features, and a two-dimensional feedback experiment using both of the features simultaneously. The two selected features were simple channel and frequency band combinations associated with change during hand and tongue movement. Inter-feature correlation and cross-correlation between features during different epochs of each task were quantified for each stage of the experiment. Our anecdotal, three subject, result suggests that while high correlation between horizontal and vertical control signal can initially preclude successful two-dimensional cursor control, a feedback-based learning strategy can be successfully employed by the subject to overcome this limitation and progressively decorrelate these control signals.10aAdolescent10aAdult10aAlgorithms10aautomated pattern recognition10acontrol systems10adecorrelation10aElectrocardiography10aElectrodes10aElectroencephalography10aevoked motor potentials10aFeedback10aFemale10afrequency10ahospitals10aHumans10aMale10aMiddle Aged10aMotor Cortex10aSignal Processing10aStatistics as Topic10aTask Performance and Analysis10aTongue10aUser-Computer Interface1 aMiller, Kai, J1 aBlakely, Timothy1 aSchalk, Gerwin1 aNijs, Marcel1 aRao, Rajesh, PN1 aOjemann, Jeffrey, G uhttp://www.ncbi.nlm.nih.gov/pubmed/1916391802173nas a2200361 4500008004100000022001400041245007200055210006900127260000900196300001200205520109300217653001501310653001001325653001501335653002401350653002901374653001101403653001101414653000901425653001601434653001701450653003501467653002401502653003401526653002801560100002001588700002101608700001901629700001701648700002101665700001701686856010801703 2008 eng d a1557-170X00aThree cases of feature correlation in an electrocorticographic BCI.0 aThree cases of feature correlation in an electrocorticographic B c2008 a5318-213 aThree human subjects participated in a closed-loop brain computer interface cursor control experiment mediated by implanted subdural electrocorticographic arrays. The paradigm consisted of several stages: baseline recording, hand and tongue motor tasks as the basis for feature selection, two closed-loop one-dimensional feedback experiments with each of these features, and a two-dimensional feedback experiment using both of the features simultaneously. The two selected features were simple channel and frequency band combinations associated with change during hand and tongue movement. Inter-feature correlation and cross-correlation between features during different epochs of each task were quantified for each stage of the experiment. Our anecdotal, three subject, result suggests that while high correlation between horizontal and vertical control signal can initially preclude successful two-dimensional cursor control, a feedback-based learning strategy can be successfully employed by the subject to overcome this limitation and progressively decorrelate these control signals.10aAdolescent10aAdult10aAlgorithms10aElectrocardiography10aEvoked Potentials, Motor10aFemale10aHumans10aMale10aMiddle Aged10aMotor Cortex10aPattern Recognition, Automated10aStatistics as Topic10aTask Performance and Analysis10aUser-Computer Interface1 aMiller, John, W1 aBlakely, Timothy1 aSchalk, Gerwin1 aNijs, Marcel1 aRao, Rajesh, P N1 aOjemann, J G uhttps://neurotechcenter.org/publications/2008/three-cases-feature-correlation-electrocorticographic-bci02662nas a2200409 4500008004100000022001400041245008400055210006900139260001200208300001000220490000600230520153900236653001501775653001001790653001801800653003701818653002001855653002401875653002601899653002701925653001301952653001101965653001101976653000901987653001301996653002802009100001902037700001602056700002602072700002002098700001602118700001702134700001302151700002102164700001902185856004802204 2008 eng d a1741-256000aTwo-dimensional movement control using electrocorticographic signals in humans.0 aTwodimensional movement control using electrocorticographic sign c03/2008 a75-840 v53 a

We show here that a brain-computer interface (BCI) using electrocorticographic activity (ECoG) and imagined or overt motor tasks enables humans to control a computer cursor in two dimensions. Over a brief training period of 12-36 min, each of five human subjects acquired substantial control of particular ECoG features recorded from several locations over the same hemisphere, and achieved average success rates of 53-73% in a two-dimensional four-target center-out task in which chance accuracy was 25%. Our results support the expectation that ECoG-based BCIs can combine high performance with technical and clinical practicality, and also indicate promising directions for further research.

10aAdolescent10aAdult10aBrain Mapping10aData Interpretation, Statistical10aDrug Resistance10aElectrocardiography10aElectrodes, Implanted10aElectroencephalography10aEpilepsy10aFemale10aHumans10aMale10aMovement10aUser-Computer Interface1 aSchalk, Gerwin1 aMiller, K J1 aAnderson, Nicholas, R1 aWilson, Adam, J1 aSmyth, Matt1 aOjemann, J G1 aMoran, D1 aWolpaw, Jonathan1 aLeuthardt, E C uhttp://www.ncbi.nlm.nih.gov/pubmed/1831081303960nas a2200325 4500008004100000022001400041245011500055210006900170260001200239300001200251490000700263520302600270653001203296653002403308653001803332653002403350653001203374653001303386653002803399653001703427653002903444653002003473100001703493700001303510700001703523700001403540700001903554700001403573856004703587 1998 eng d a0009-732200aQuantification of effects of global ischemia on dynamics of ventricular fibrillation in isolated rabbit heart.0 aQuantification of effects of global ischemia on dynamics of vent c10/1998 a1688-960 v983 a

BACKGROUND: 

Ventricular fibrillation (VF) leads to global ischemia of the heart. After 1 to 2 minutes of onset, the VF rate decreases and appears more organized. The objectives of this study were to determine the effects of no-flow global ischemia on nonlinear wave dynamics and establish the mechanism of ischemia-induced slowing of the VF rate.

METHODS AND RESULTS: 

Activation patterns of VF in the Langendorff-perfused rabbit heart were studied with the use of 2 protocols: (1) 15 minutes of no-flow global ischemia followed by reperfusion (n=7) and (2) decreased excitability induced by perfusion with 5 micromol/L of tetrodotoxin (TTX) followed by washout (n=3). Video imaging ( approximately 7500 pixels per frame; 240 frames per second) with a voltage-sensitive dye, ECG, and signal processing (fast Fourier transform) were used for analysis. The dominant frequency of VF decreased from 13.5+/-1.3 during control to 9.3+/-1.4 Hz at 5 minutes of global ischemia (P<0.02). The dominant frequency decreased from 13.9+/-1.1 during control to 7.0+/-0.3 Hz at 2 minutes of TTX infusion (P<0.001). The rotation period of rotors on the epicardial surface (n=27) strongly correlated with the inverse dominant frequency of the corresponding episode of VF (R2=0. 93). The core area, measured for 27 transiently appearing rotors, was 5.3+/-0.7 mm2 during control. A remarkable increase in core area was observed both during global ischemia (13.6+/-1.7 mm2; P<0.001) and TTX perfusion (16.8+/-3.6 mm2; P<0.001). Density of wave fronts decreased during both global ischemia (P<0.002) and TTX perfusion (P<0.002) compared with control.

CONCLUSIONS: 

This study suggests that rotating spiral waves are most likely the underlying mechanism of VF and contribute to its frequency content. Ischemia-induced decrease in the VF rate results from an increase in the rotation period of spiral waves that occurs secondary to an increase in their core area. Remarkably, similar findings in the TTX protocol suggest that reduced excitability during ischemia is an important underlying mechanism for the changes seen.

10aAnimals10aElectrocardiography10aLinear Models10aMyocardial Ischemia10aRabbits10aRotation10aSodium Channel Blockers10aTetrodotoxin10aVentricular Fibrillation10aVideo Recording1 aMandapati, R1 aAsano, Y1 aBaxter, Bill1 aGray, R A1 aDavidenko, J M1 aJalife, J uhttp://www.ncbi.nlm.nih.gov/pubmed/977833605025nas a2200385 4500008004100000022001400041245011300055210006900168260001200237300001100249490000700260520391000267653002204177653001204199653002704211653002504238653002404263653001004287653002804297653004004325653002704365653002904392653001404421653001604435653001404451653001404465653001204479653002404491100001304515700001904528700001704547700001404564700001404578856004704592 1997 eng d a0735-109700aOptical mapping of drug-induced polymorphic arrhythmias and torsade de pointes in the isolated rabbit heart.0 aOptical mapping of druginduced polymorphic arrhythmias and torsa c03/1997 a831-420 v293 a

OBJECTIVES: 

This study sought to 1) test the hypothesis that in the setting of bradycardia and drug-induced action potential prolongation, multiple foci of early afterdepolarizations (EADs) result in beat to beat changes in the origin and direction of the excitation wave front and are responsible for polymorphic arrhythmias; and 2) determine whether EADs may initiate nonstationary reentry, giving rise to the typical torsade de pointes (TDP) pattern.

BACKGROUND: 

In the past, it has been difficult to associate EADs or reentry with the undulating electrocardiographic (ECG) patterns of TDP.

METHODS: 

A voltage-sensitive dye was used for high resolution video imaging of electrical waves on the epicardial and endocardial surface of the Langendorff-perfused rabbit heart. ECG and monophasic action potentials from the right septal region were also recorded. Bradycardia was induced by ablation of the atrioventricular node.

RESULTS: 

Perfusion of low potassium chloride Tyrode solution plus quinidine led to prolongation of the action potential and the QT interval. Eventually, EADs and triggered activity ensued, giving rise to intermittent episodes of polymorphic arrhythmia. In one experiment, triggered activity was followed by a long episode of vortex-like reentry with an ECG pattern characteristic of TDP. However, in most experiments, focal activity of varying origins and propagation patterns was observed. Triggered responses also showed varying degrees of local block. Similar results were obtained with E-4031. Burst pacing both at control conditions and in the presence of quinidine consistently led to vortex-like reentry whose ECG pattern resembled TDP. However, the cycle length of the arrhythmia with quinidine was longer than that for control ([mean +/- SEM] 194 +/- 12 vs. 132 +/- 8 ms, p < 0.03).

CONCLUSIONS: 

Drug-induced polymorphic ventricular arrhythmias may result from beat to beat changes in wave propagation patterns initiated by EADs or EAD-induced nonstationary reentrant activity. In contrast, burst pacing-induced polymorphic tachycardia in the presence or absence of drugs is the result of nonstationary reentrant activity.

10aAction Potentials10aAnimals10aAnti-Arrhythmia Agents10aArrhythmias, Cardiac10aElectrocardiography10aHeart10aHeart Conduction System10aImage Processing, Computer-Assisted10aModels, Cardiovascular10aOrgan Culture Techniques10aPerfusion10aPiperidines10aPyridines10aQuinidine10aRabbits10aTorsades de Pointes1 aAsano, Y1 aDavidenko, J M1 aBaxter, Bill1 aGray, R A1 aJalife, J uhttp://www.ncbi.nlm.nih.gov/pubmed/909153103253nas a2200301 4500008004100000022001400041245009200055210006900147260001200216300001200228490000700240520238200247653001702629653001202646653003102658653002402689653001702713653002402730653002702754653001002781653002902791100001902820700001702839700001702856700001702873700001402890856004702904 1995 eng d a0009-733000aEffects of pacing on stationary reentrant activity. Theoretical and experimental study.0 aEffects of pacing on stationary reentrant activity Theoretical a c12/1995 a1166-790 v773 a

It is well known that electrical pacing may either terminate or change the rate and/or ECG appearance of reentrant ventricular tachycardia. However, the dynamics of interaction of reentrant waves with waves initiated by external pacing are poorly understood. Prevailing concepts are based on simplistic models in which propagation occurs in one-dimensional rings of cardiac tissue. Since reentrant activation in the ventricles occurs in two or three dimensions, such concepts might be insufficient to explain the mechanisms of pacing-induced effects. We used numerical and biological models of cardiac excitation to explore the phenomena, which may take place as a result of electrical pacing during functionally determined reentry. Computer simulations of a two-dimensional array of electrically coupled FitzHugh-Nagumo cells were used to predict the response patterns expected from thin slices of sheep ventricular epicardial muscle, in which self-sustaining reentrant activity in the form of spiral waves was consistently initiated by premature stimulation and monitored by means of video mapping techniques. The results show that depending on their timing and shape, externally induced waves may collide with the self-sustaining spiral and result in one of three possible outcomes: (1) direct annihilation of the spiral, (2) multiplication of the spiral, or (3) shift of the spiral center (ie, core). Multiplication and shift of the spiral core were attended by changes in rate and morphology of the arrhythmia as seen by "pseudo-ECGs." Furthermore, delayed termination (ie, termination of the activity one to three cycles after the stimulus) occurred after both multiplication and shift of the spiral center. Both numerical predictions and experimental results support the hypothesis that whether a pacing stimulus will terminate a reentrant arrhythmia or modify its ECG appearance depends on whether the interactions between the externally induced wave and the spiral wave result in the de novo formation of one or more "wavebreaks." The final outcome depends on the stimulus parameters (ie, position and size of the electrodes and timing of the stimulus) as well as on the position of the newly formed wavebreak(s) in relation to that of the original wave.

10aAcceleration10aAnimals10aCardiac Pacing, Artificial10aComputer Simulation10aDeceleration10aElectrocardiography10aModels, Cardiovascular10aSheep10aTachycardia, Ventricular1 aDavidenko, J M1 aSalomonsz, R1 aPertsov, A V1 aBaxter, Bill1 aJalife, J uhttp://www.ncbi.nlm.nih.gov/pubmed/758623000781nas a2200289 4500008004100000022001400041245004000055210003900095260001200134300003200146490000800178653001200186653002400198653002400222653002100246653002700267653001200294653002900306100001400335700001400349700001600363700001700379700001200396700001900408700001700427856004700444 1995 eng d a0036-807500aMechanisms of cardiac fibrillation.0 aMechanisms of cardiac fibrillation c11/1995 a1222-3; author reply 1224-50 v27010aAnimals10aComputer Simulation10aElectrocardiography10aHeart Ventricles10aModels, Cardiovascular10aRabbits10aVentricular Fibrillation1 aGray, R A1 aJalife, J1 aPanfilov, A1 aBaxter, Bill1 aCabo, C1 aDavidenko, J M1 aPertsov, A V uhttp://www.ncbi.nlm.nih.gov/pubmed/750205504137nas a2200313 4500008004100000022001400041245013200055210006900187260001300256300001200269490000700281520321100288653001203499653002403511653001003535653004003545653002703585653001403612653001203626653002903638100001403667700001403681700001603695700001703711700001203728700001903740700001703759856004703776 1995 eng d a0009-732200aNonstationary vortexlike reentrant activity as a mechanism of polymorphic ventricular tachycardia in the isolated rabbit heart.0 aNonstationary vortexlike reentrant activity as a mechanism of po c05/1995  a2454-690 v913 a

BACKGROUND: 

Ventricular tachycardia may result from vortexlike reentrant excitation of the myocardium. Our general hypothesis is that in the structurally normal heart, these arrhythmias are the result of one or two nonstationary three-dimensional electrical scroll waves activating the heart muscle at very high frequencies.

METHODS AND RESULTS: 

We used a combination of high-resolution video imaging, electrocardiography, and image processing in the isolated rabbit heart, together with mathematical modeling. We characterized the dynamics of changes in transmembrane potential patterns on the epicardial surface of the ventricles using optical mapping. Image processing techniques were used to identify the surface manifestation of the reentrant organizing centers, and the location of these centers was used to determine the movement of the reentrant pathway. We also used numerical simulations incorporating Fitzhugh-Nagumo kinetics and realistic heart geometry to study how stationary and nonstationary scroll waves are manifest on the epicardial surface and in the simulated ECG. We present epicardial surface manifestations (reentrant spiral waves) and ECG patterns of nonstationary reentrant activity that are consistent with those generated by scroll waves established at the right and left ventricles. We identified the organizing centers of the reentrant circuits on the epicardial surface during polymorphic tachycardia, and these centers moved during the episodes. In addition, the arrhythmias that showed the greatest movement of the reentrant centers displayed the largest changes in QRS morphology. The numerical simulations showed that stationary scroll waves give rise to monomorphic ECG signals, but nonstationary meandering scroll waves give rise to undulating ECGs characteristic of torsade de pointes.

CONCLUSIONS: 

Polymorphic ventricular tachycardia in the healthy, isolated rabbit heart is the result of either a single or paired ("figure-of-eight") nonstationary scroll waves. The extent of the scroll wave movement corresponds to the degree of polymorphism in the ECG. These results are consistent with our numerical simulations that showed monomorphic ECG patterns of activity for stationary scroll waves but polymorphic patterns for scroll waves that were nonstationary.

10aAnimals10aElectrocardiography10aHeart10aImage Processing, Computer-Assisted10aModels, Cardiovascular10aPerfusion10aRabbits10aTachycardia, Ventricular1 aGray, R A1 aJalife, J1 aPanfilov, A1 aBaxter, Bill1 aCabo, C1 aDavidenko, J M1 aPertsov, A V uhttp://www.ncbi.nlm.nih.gov/pubmed/7729033