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Am J Physiol Heart Circ Physiol (December 5, 2008). doi:10.1152/ajpheart.00952.2008
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Submitted on August 29, 2008
Revised on November 20, 2008
Accepted on November 24, 2008

A Computational Study of Mother Rotor VF in the Human Ventricles

Rikkert H. Keldermann1*, Kirsten H. W. J. ten Tusscher1, Martyn P Nash2, Chris P. Bradley3, Rok Hren4, Peter Taggart5, and Alexander V. Panfilov6

1 Utrecht University
2 University of Auckland
3 University of Oxford
4 University of Ljubljana
5 University College Hospital, London
6 University of Utrecht

* To whom correspondence should be addressed. E-mail: R.H.Keldermann{at}bio.uu.nl.

Sudden cardiac death is one of the major causes of death in the industrialized world. It is most often caused by a cardiac arrhythmia called ventricular fibrillation (VF). Despite its large social and economical impact, the mechanisms for VF in the human heart yet remain to be identified. Two of the most frequently discussed mechanisms observed in experiments with animal hearts are the multiple wavelet and the mother rotor hypotheses. Most recordings of VF in animal hearts are consistent with the multiple wavelet mechanism. However, in animal hearts, mother rotor fibrillation has also been observed. For both multiple wavelet and mother rotor VF, cardiac heterogeneity plays an important role. Clinical data of action potential restitution measured from the surface of human hearts were recently published. These in vivo data show a substantial degree of spatial heterogeneity. Using these clinical restitution data, we study the dynamics of VF in the human heart using a heterogeneous computational model of the human ventricles. We hypothesized that this observed heterogeneity can serve as a substrate for mother rotor fibrillation. We found that, based on these data, mother rotor VF can occur in the human heart and that ablation of the mother rotor terminates VF. Furthermore, we found that both mother rotor and multiple wavelet VF can occur in the same heart depending on the initial conditions at the onset of VF. We studied the organization of these two types of VF in terms of filament numbers, excitation periods and frequency domains. We conclude that mother rotor fibrillation is a possible mechanism of VF in the human heart.







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