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1 Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio, USA
2 ; Institut Non Lineaire de Nice, Nice, France
* To whom correspondence should be addressed. E-mail: vpn2{at}case.edu.
The outcome of defibrillation shocks is determined by the nonlinear transmembrane potential response (
Vm) induced by strong external electrical field in cardiac cells. We investigated contribution of electroporation to
Vm transients during high-intensity shocks using optical mapping. Rectangular and ramp stimuli (10-20 ms) of different polarities and intensities were applied to the rabbit heart epicardium during plateau phase of the action potential.
Vm were optically recorded under the custom 6-mm-diameter electrode using voltage-sensitive dye. Gradual increase of cathodal and well as anodal stimulus strength was associated with: a) saturation and subsequent reduction of
Vm; b) post-shock diastolic resting potential (RP) elevation, c) post-shock action potential amplitude (APA) reduction. Weak stimuli induced monotonic
Vm response and did not affect RP level. Strong shocks produced non-monotonic
Vm response, caused RP elevation and reduction of post-shock APA. The maximum positive and maximum negative
Vm were recorded at 170±20 mA/cm2 for cathodal and at 240±30 mA/cm2 for anodal stimuli, respectively (mean ± SEM, n=8, p=0.003). RP elevation reached 10% of APA at stimulus strength 320±40 mA/cm2 for both polarities. Strong ramp stimuli (20 ms 600 mA/cm2) induced non-monotonic
Vm response, reaching the same largest positive and negative values as for rectangular shocks. Transition from monotonic to non-monotonic morphology correlates with RP elevation and APA reduction, which is consistent with cell membrane electroporation. Strong shocks resulted in Propidium Iodide uptake, suggesting sarcolemma electroporation. Conclusions: Electroporation is a likely explanation of the saturation and non-monotonic nature of cellular responses reported for strong electric stimuli.
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