【精选】A dynamic action potential model analysis of shock-induced aftereffects in ventricular muscle by rev.pdf

18 IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, VOL. 49, NO. 1, JANUARY 2002 A Dynamic Action Potential Model Analysis of Shock-Induced Aftereffects in Ventricular Muscle by Reversible Breakdown of Cell Membrane Katsuhiro Ohuchi*, Member, IEEE, Yasuhiro Fukui, Member, IEEE, Ichiro Sakuma, Associate Member, IEEE, Nitaro Shibata, Haruo Honjo, and Itsuo Kodama Abstract— To elucidate the subcellular mechanism underlying an induction of new ventricular tachyarrhythmias, refibrillation, the aftereffects of high-intensity dc shocks, a small pore, which and inhibition of cardiac pump function [1]–[5]. Cellular and mimics reversible breakdown of the cell membrane (electropora- subcellular mechanisms for such postshock cardiac dysfunc- tion), was incorporated into the phase-2 Luo–Rudy (L-R) model of ventricular action potentials. The pore size was set to occupy tion remains to be clarified. Kodama et al. [6] examined the 0.15%–0.25% of the total cell membrane during the 10-ms shock. effects of electric field stimulation, at voltage gradients em- The pore was assumed to decrease after the shock exponentially ployed for clinical dc defibrillation shocks, on the transmem- with a time constant of 100–1400 ms to simulate resealing process. brane potential and contraction of isolated guinea pig ventric- In normal myocytes, the pore formation results in a delay of re- ular muscle. They revealed that dc stimulation above a certain polarization of the shocked action potential, which is followed by prolonged depolarization and oscillation of membrane potential intensity (15 V/cm) causes a prolonged depolarization, an os- like early afterdepolarization (EAD). Ti