Maintenance of Ventricular Fibrillation in Heterogeneous Ventricle

Although ventricular fibrillation (VF) is the prevalent cause of sudden cardiac death, the mechanisms that underlie VF remain elusive. One possible explanation is that VF is driven by a single robust rotor that is the source of wavefronts that break-up due to functional heterogeneities. Previous 2D computer simulations have proposed that a heterogeneity in background potassium current (IK1) can serve as the substrate for the formation of mother rotor activity. This study incorporates IK1 heterogeneity between the left and right ventricle in a realistic 3D rabbit ventricle model to examine its effects on the organization of VF. Computer simulations show that the IK1 heterogeneity contributes to the initiation and maintenance of VF by providing regions of different refractoriness which serves as sites of wave break and rotor formation. A single rotor that drives the fibrillatory activity in the ventricle is not found in this study. Instead, multiple sites of reentry are recorded throughout the ventricle. Calculation of dominant frequencies for each myocardial node yields no significant difference between the dominant frequency of the LV and the RV. The 3D computer simulations suggest that IK1 spatial heterogeneity alone can not lead to the formation of a stable rotor