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Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294
Transmembrane potential change
(
Vm) during
shocks was recorded by a double-barrel microelectrode in 12 isolated
guinea pig papillary muscles. After 10 S1 stimuli, square-wave S2
shocks of both polarities were given consisting of 10-ms monophasic and 10/10-ms and 5/5-ms biphasic waveforms that created potential gradients
from 1.1 ± 0.3 to 11.9 ± 0.4 V/cm. S2 shocks were applied with
30, 60- to 70-, and 90- to 130-ms S1-S2 coupling intervals so that they
occurred during the plateau, late portion of the plateau, and
phase 3 of the action potential,
respectively. Some shocks were given across as well as along the fiber
orientation. The shocks caused hyperpolarization with one polarity and
depolarization with the opposite polarity. The ratio of the magnitude
of hyperpolarization to that of depolarization at the three S1-S2
coupling intervals was 1.5 ± 0.3, 1.1 ± 0.2, and 0.5 ± 0.2, respectively.
Vm during the
shock was significantly greater for the monophasic than for the two
biphasic shocks. The prolongation of total repolarizing time (TRT) was
significantly greater for monophasic (119.8 ± 19.1%) and 10/10-ms
biphasic (120.5 ± 18.2%) than for 5/5-ms biphasic (113.0 ± 12.9%) waveforms. The dispersion of the normalized TRT between
instances of hyperpolarization and depolarization caused by the two
shock polarities was 7.4 ± 7.1% for monophasic, 3.0 ± 4.1%
for 10/10-ms biphasic, and 2.8 ± 3.1% for 5/5-ms biphasic shocks
(P < 0.05 for monophasic vs.
biphasic). Shock fields along fibers produced a larger
Vm and
prolongation of TRT than those across fibers. We conclude that
1) a change in shock polarity causes
an asymmetrical change in membrane polarization depending on shock
timing; 2) the 5/5-ms biphasic
waveform causes the smallest
Vm, prolongs
repolarization the least, and causes the smallest polarity-dependent
dispersion; and 3) the changes in
transmembrane potential and repolarization are influenced by fiber orientation.
depolarization; hyperpolarization ; action potential duration; defibrillation
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