NON-UNIFORMITY OF THE DISTRIBUTION OF ELECTRICAL TRANSMEMBRANE POTENTIALS IN CARDIAC DEFIBRILLATION
https://doi.org/10.15360/1813-9779-2015-6-38-47
Abstract
The need for emergency cessation of ventricular fibrillation is one of the problems of modern reanimatology. In spite of searches for novel methods, there is the only effective method — electrical cardiac defibrillation.
Objective: to investigate the effect of different forms of pulses on cell membranes in a model experiment and to assess their use for effective cardiac defibrillation.
Materials and methods. The Maxwell model was used for theoretical analysis of the spatial distribution of an electric field in the red blood cell membrane. The electric effect on a single cell was calculated using the experimental findings and the equivalent electrical circuit of the myocardial structure during a defibrillation procedure. The cardiomyocyte membrane potential upon exposure to defibrillator discharge was estimated. Exposure of the red blood cell membrane to single, two unipolar and two heteropolar pulses was examined.
Results. There is non-additivity of speeds upon double exposure as compared to single one. Single pulse causes a lower effect of electroporation than two double pulses. Hyperpolarization and depolarization processes in the cardiomyocyte membranes occur successively during electrical cardiac defibrillation.
Conclusion. Two heteropolar pulses cause an effect of biological membrane electroporation with a greater probability than two unipolar ones.
About the Authors
O. E. Gudkova
V. A. Negovsky Research Institute of General Reanimatology
Russian Federation
25, Petrovka St, Build. 2, Moscow 107031, Russia
Russian Federation
25, Petrovka St, Build. 2, Moscow 107031, Russia
A. P. Kozlov
I. M. Sechenov First Moscow State Medical University, Ministry of Health of Russia
Russian Federation
8, Trubetskaya St., Build. 2, Moscow 119991, Russia
Russian Federation
8, Trubetskaya St., Build. 2, Moscow 119991, Russia
References
1. Kozlova E.K., Moroz V.V., Bogushevich M.S., Alekseyeva P.Yu., Chernysh A.M. Vliyanie formy elektricheskogo impulsa na elektroporatsiyu membran eritrotsitov. Obshchaya Reanimatologiya. [Impact of electrical pulse pattern on red blood cell membranous electroporation. General Reanimatology]. 2005; 1 (1): 42—46. http://dx.doi.org/10. 15360/1813-9779-2005-1-42-46. [In Russ.]
2. Gurvich N.L. Osnovnye printsipy defibrillyatsii serdtsa. [The basic principles of defibrillation]. Moscow: Meditsina Publishers; 1975: 170. [In Russ.]
3. Chernysh A.M. Biomekhanika neodnorodnosti serdechnoi myshtsy. [Biomechanics heterogeneity of the heart muscle]. Moscow: Nauka; 1993: 372. [In Russ.]
4. Moroz V.V., Bogushevich M.S., Chernysh A.M., Kozlova E.K., Sharakshane A.S. Eksperimentalnoe issledovanie deistviya defibrilliruyushchikh impulsov raznoi formy na biologicheskie membrany. [Effect of defibrillation pulses of different shapes on biomembranes: experimental study]. Byulleten Eksperimentalnoi Biologii i Meditsiny. 2004; 137 (2): 120—123. http://dx.doi.org/10.1023/B:BEBM.0000028118.86481.f6. PMID: 15273753. [In Russ.]
5. Moroz V.V., Kozlova E.K., Bogushevich M.S., Alekseyeva P.Yu., Chernysh A.M. Vliyanie perftorana na modifitsirovannye elektricheskimi impulsami membrany eritrotsitov. Obshchaya Reanimatologiya. [Effect of perfluorane on electric pulsemodified red blood cell membranes. General Reanimatology]. 2005; 1 (3): 5—10. http://dx.doi.org/10.15360/1813-9779-2005-3-5-10. [In Russ.]
6. Gennis R. Biomembrany. [Biomembranes]. Moscow: Mir; 1997: 624. [In Russ.]
7. De Bruin K., Krassowska W. Modeling electroporation in a single cell. I. Effects of field strength and rest potential. Biophys. J. 1999; 77 (3): 1213—1224. http://dx.doi.org/10.1016/S0006-3495(99)76973-0. PMID: 10465736
8. Tovar O., Tung L. Electroporation of cardiac cell membranes with monophasis or biphasic rectangular pulses. Pacing Clin. Electrophysiol. 1991; (11 Pt 2): 1887—1892. PMID: 1721194
9. Walcott G.P., Killingsworth C.R., Ideker R.E. Do clinically relevant transthoracic energies cause myocardial damage and dysfunction? Resuscitation. 2003; 59 (1): 59—70. http://dx.doi.org/10.1016/S0300-9572(03)00161-8. PMID: 14580735
10. Wenzel V., Voelckel W.G., Krismer A.C., Mayr V.D., Strohmenger H.U., Baubin M.A., Wagner Berger H., Stallinger A., Lindner K.H.; American Heart Association; European Resuscitation Council. The new international guidelines for cardipulmonary resuscitation: an analysis and comments on the most important changes. Anaesthesist. 2001; 50 (5): 342—357. PMID: 11417270
11. Bogushevich M.S., Vostrikov V.A., Chernysh A.M. Eksperimentalnye i teoreticheskie problemy elektricheskoi defibrillyatsii serdtsa. [Experimental and theoretical problems of electrical defibrillation]. Vestnik RAMN. 1997; 10: 36—44. [In Russ.]
12. Vostrikov V.A., Syrkin A.L., Kholin P.V., Razumov K.V. Vnutribolnichnaya defibrillyatsiya zheludochkov serdtsa: effektivnost bipolyarnogo kvazis-inusoidalnogo impulsa. [Inpatient cardiac defibrillation: efficacy of bipolar sinusoidal impulse]. Kardiologiya. 2003; 43 (12): 51—58. PMID: 14671552. [In Russ.]
13. Moroz V.V., Bogushevich M.S., Vostrikov V.A., Kozlova E.K., Chernysh A.M. Vliyanie formy vysokovoltnogo impulsa na effekt defibrillyatsii. [The shape of highvoltage impulse and the effect of defibrillation]. Anesteziologiya i Reanimatologiya. 2002; 6: 60—63. PMID: 12611162. [In Russ.]
14. Moroz V.V., Golubev A.M., Chernysh A.M., Kozlova E.K., Vasilyev V.Yu., Gudkova O.E., Sergunova V.A., Fedorova M.S. Izmeneniya struktury poverkhnosti membran eritrotsitov pri dlitelnom khranenii donorskoi krovi. Obshchaya Reanimatologiya. [Structural changes in the surface of red blood cell membranes during longterm donor blood storage. General Reanimatology]. 2012; 8 (1): 5—12. http://dx.doi.org/ 10.15360/1813-9779-2012-1-5. [In Russ.]
15. Chazov E.I., Golitsyn S.P. Rukovodstvo po narusheniyam ritmov serdtsa. [Guidelines for heart rhythm disturbances]. Moscow: GEOTAR-Media; 2010: 409. [In Russ.]
16. Moroz V.V., Golubev A.M., Kozlova E.K., Afanasyev A.V., Gudkova O.E., Novoderzhkina I.S., Marchenkov Yu.V., Kuzovlev A.N., Zarzhetsky Yu.V., Kostin A.I., Volkov D.P., Yakovlev V.N. Dinamika morfologicheskikh izmenenii eritrotsitov i biokhimicheskikh pokazatelei konservirovannoi tselnoi krovi v razhlichnye sroki khraneniya. Obshchaya Reanimatologiya. [Time course of morphological changes in red blood cells and stored whole blood biochemical parameters in different storage periods. General Reanimatology]. 2013; 9 (1): 5—13. http://dx.doi.org/10.15360/1813-9779-2013-1-5. [In Russ.]
17. Moroz V.V., Chernysh A.M., Bogushevich M.S., Kozlova E.K., Bliznyuk U.A., Alekseyeva P.Yu., Kozlov A.P. Skrytye povrezhdeniya eritrotsitarnykh membran pri fizicheskikh i farmakologicheskikh vozdeistviyakh. Obshchaya Reanimatologiya. [Occult erythrocytic membrane damages upon physical and pharmacological exposures. General Reanimatology]. 2006; 2 (5—6): 55—60. http://dx.doi.org/10. 15360/1813-9779-2006-6-55-60. [In Russ.]
Review
For citations:
Gudkova O.E., Kozlov A.P. NON-UNIFORMITY OF THE DISTRIBUTION OF ELECTRICAL TRANSMEMBRANE POTENTIALS IN CARDIAC DEFIBRILLATION. General Reanimatology. 2015;11(6):38-47. https://doi.org/10.15360/1813-9779-2015-6-38-47
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