Ventricular fibrillation: triggers, mechanisms and therapies.
Ventricular fibrillation (VF) is a common, life-threatening arrhythmia responsible for significant morbidity and mortality. Due to challenges in safely mapping VF, a comprehensive understanding of its mechanisms remains elusive. Recent findings have provided new insights into mechanisms that sustain early VF. Notably, the central role of electrical rotors and catheter-based ablation of VF rotor substrate have been recently reported. In this article, we will review data regarding four stages of VF: initiation, transition, maintenance and evolution. We will discuss the particular mechanisms for each stage and therapies targeting these mechanisms. We also examine inherited arrhythmia syndromes, including the mechanisms and therapies specific to each. We hope that the overview of VF outlined in this work will assist other investigators in designing future therapies to interrupt this life-threatening arrhythmia.
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.|Department of Medicine, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
David E
DE
Krummen
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.|Department of Medicine, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
Gordon
G
Ho
Department of Bioengineering, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
Christopher T
CT
Villongco
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.|Department of Medicine, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
Justin
J
Hayase
Department of Medicine, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.|Department of Medicine, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA.
Amir A
AA
Schricker
D017115:Catheter Ablation; D006801:Humans; D014693:Ventricular Fibrillation / Q000209:etiology* / Q000628:therapy*
action potential duration; electrical alternans; electrophysiology; focal sources; premature ventricular complexes; rotors; ventricular fibrillation; ventricular tachycardia