Regional frequency variation during human ventricular fibrillation

Umapathy, K.; Masse, S.; Sevaptsidis, E.; Asta, J.; Ross, H.; Thavandiran, N.; Nair, K.; Farid, T.; Cusimano, R.; Rogers, J.; Krishnan, S.; Nanthakumar, K.

doi:10.1016/j.medengphy.2009.05.009

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Volume 31, Issue 8 , Pages 964-970, October 2009

Regional frequency variation during human ventricular fibrillation

K. Umapathy
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
- Ryerson University, Toronto, ON, Canada
S. Masse
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
E. Sevaptsidis
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
J. Asta
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
H. Ross
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
N. Thavandiran
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
K. Nair
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
T. Farid
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
R. Cusimano
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
J. Rogers
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
S. Krishnan
- Ryerson University, Toronto, ON, Canada
- Corresponding author at: Department of Electrical and Computer Engineering, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada. Tel.: +1 416 979 5334; fax: +1 416 979 5280.
- The senior authorship is shared between these authors.
K. Nanthakumar
- The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, Toronto, ON, Canada
- The senior authorship is shared between these authors.

Received 18 November 2008; received in revised form 12 May 2009; accepted 13 May 2009. published online 29 June 2009.

Abstract

Quantifying the regional frequency variation in ventricular fibrillation (VF) may lead to focal strategies in treating human VF. We hypothesized that during human VF there are quantifiable regional frequency variations in the ventricles and they relate to underlying fixed myocardial substrate. In eight myopathic human hearts, we studied 35 VF episodes. The electrograms during VF were acquired simultaneously from the epicardium and endocardium using 2 electrode arrays each consisting of 112 electrodes. Regional characterization was performed using a ratio parameter derived from the dominant frequency analysis of the electrograms. The findings were related to the anatomical substrate using bipolar voltage maps. The results of the analysis indicate that LV had a larger dominant frequency (DF) span than RV () while there was no significant difference () in the DF span between LV freewall (FW) and septum (SE). Correlation of areas of abnormal myocardium with the dominant frequency feature matched only in 50% of the cases indicating that ion channel heterogeneity and time-varying physiological factors may play an important role in maintaining VF.