ArticleHeart rhythm2008
Atria are more susceptible to electroporation than ventricles: implications for atrial stunning, shock-induced arrhythmia and defibrillation failure.
Article in Heart rhythm, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 31 citations in OpenAlex.
- Radiofrequency, Cryoablation, and Pulsed Field Ablation for Atrial Fibrillation: Mechanisms, Preclinical Evidence, and Clinical Outcomes.Biomedicines · 2026Review
- Correlation of cavotricuspid isthmus dynamics with clinical parameters: insights from interventional cardiac magnetic resonance imaging.European heart journal. Imaging methods and practice · 2025Article
- HumanFrontiers in physiology · 2022Article
- AC Pulsed Field Ablation Is Feasible and Safe in Atrial and Ventricular Settings: A Proof-of-Concept Chronic Animal Study.Frontiers in bioengineering and biotechnology · 2020Article
- Irreversible electroporation: Proceed with caution.Heart rhythm · 2018Article
- Excitation and injury of adult ventricular cardiomyocytes by nano- to millisecond electric shocks.Scientific reports · 2018Article
- Chamber-specific differences in human cardiac fibroblast proliferation and responsiveness toward simvastatin.American journal of physiology. Cell physiology · 2016Article
- "Atrial torsades de pointes" Induced by Low-Energy Shock From Implantable-Cardioverter Defibrillator.Indian pacing and electrophysiology journal · 2013Article
- Ionic mechanism of shock-induced arrhythmias: role of intracellular calcium.Heart rhythm · 2012Article
- Low-energy multistage atrial defibrillation therapy terminates atrial fibrillation with less energy than a single shock.Circulation. Arrhythmia and electrophysiology · 2011Article
- Effects of KATP channel openers diazoxide and pinacidil in coronary-perfused atria and ventricles from failing and non-failing human hearts.Journal of molecular and cellular cardiology · 2011Article
- Termination of sustained atrial flutter and fibrillation using low-voltage multiple-shock therapy.Heart rhythm · 2011Article
- Optical mapping of the isolated coronary-perfused human sinus node.Journal of the American College of Cardiology · 2010Article
- Transmural dispersion of repolarization in failing and nonfailing human ventricle.Circulation research · 2010Article
- Differential K(ATP) channel pharmacology in intact mouse heart.Journal of molecular and cellular cardiology · 2010Article
- Structural and functional evidence for discrete exit pathways that connect the canine sinoatrial node and atria.Circulation research · 2009Article
- Electrophysiological mechanisms of antiarrhythmic protection during hypothermia in winter hibernating versus nonhibernating mammals.Heart rhythm · 2008Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDefibrillation shock is known to induce atrial stunning, which is electrical and mechanical dysfunction.
objectiveWe hypothesized that atrial stunning is caused by higher atrial susceptibility to electroporation vs ventricles. We also hypothesize that electroporation may be responsible for early recurrence of atrial fibrillation.
methodsWe investigated electroporation induced by 10-ms epicardial high-intensity shocks applied locally in atria and ventricles of Langendorff-perfused rabbit hearts (n = 12) using optical mapping.
resultsElectroporation was centered at the electrode and was evident from transient diastolic depolarization and reduction of action potential amplitude and maximum upstroke derivative. Electroporation was voltage-dependent and polarity-dependent and was significantly more pronounced in the atria vs ventricles (P <.01), with a summary 50% of Effective Dose (ED50) for main measured parameters of 9.2 +/- 3.6 V/cm and 13.6 +/- 3.2 V/cm in the atria vs 37.4 +/- 1.5 V/cm and 48.4 +/- 2.8 V/cm in the ventricles, for anodal and cathodal stimuli, respectively. In atria (n = 5), shocks of both polarities (27.2 +/- 1.1 V/cm) transiently induced conduction block and reentry around the inexcitable area. Electroporation-induced ectopic activity was a possible trigger for reentry. However, in the thicker ventricles, electroporation and resulting conduction slowing and block were restricted to the surface only, preventing complete block and arrhythmia. The upstroke morphology revealed that the wave front dived below the electroporated region and resurfaced into unaffected epicardial tissue.
conclusionWe showed that the atria are more vulnerable to electroporation and resulting block and arrhythmia than the ventricles.
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