title: Method of post-shock synchronized pacing in the excitable gaps.
abstract: Ventricular fibrillation (VF) can be synchronized with a novel synchronized pacing technique (SyncP) using low-energy pacing pulses, which causes pace termination of VF. Synchronized pacing (SyncP) is defined as optical recording guided real-time detection and stimulation of spatiotemporal excitable gaps. In this paper, we investigate the effect of post-shock SyncP strategy on improvement of defibrillation efficacy. After a near-threshold defibrillation shock, when the reference site detected the earliest activation of the reinitiated VF, a 5-mA electric stimulus was delivered from the post-shock pacing electrode to depolarize the excitable gap. This area of wavefront synchronization may lead to a change in the timing of VF propagation, which is important for VF termination. Here, we implemented the concept of post-shock synchronized pacing by a real-time feedback mechanism and demonstrated a successful VF termination by the post-shock SyncP strategy. Further optimization of this technique may prove effective in improving the defibrillation efficacy for low-energy ventricular defibrillation.
authors.affiliation: Dept. of Medicine, Cedars-Sinai Med. Center, Los Angeles, CA 90048, USA. liang.tang@cshs.org
authors.forename: Liang
authors.initials: L
authors.lastname: Tang
authors.forename: Gyo-Seung
authors.initials: GS
authors.lastname: Hwang
authors.forename: Lin
authors.initials: L
authors.lastname: Yang
authors.forename: Shien-Fong
authors.initials: SF
authors.lastname: Lin
mesh_terms: D000818:Animals; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D002309:Cardiology / Q000295:instrumentation* / Q000379:methods; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation / Q000379:methods; D004566:Electrodes; D004867:Equipment Design; D006321:Heart / Q000033:anatomy & histology; D006329:Heart Conduction System; D011817:Rabbits; D013997:Time Factors; D014693:Ventricular Fibrillation