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Mechanisms of Isolated Cell Stimulation

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Cardiac Bioelectric Therapy

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It is a common practice in several fields of modern science to reduce a complex system to its simplest unit to gain fundamental insights into phenomena of interest. Field stimulation of cardiac cell is no different. Understanding the effects of an electrical shock at the simplest unit of cardiac tissue, an isolated cardiac cell, can lend valuable insights into mechanisms of field stimulation, especially those involved in phenomena such as fibrillation and defibrillation. These mechanisms have remained largely unresolved despite defibrillation having been applied clinically for over 60 years1 and become the mainstay of clinical medicine with the advent of implantable cardioverter-defibrillators (ICDs)2–4 and automatic external defibrillators (AED).5 Taking a reductionism approach, this chapter discusses the field-induced responses of single cardiac cells to electric field stimulation. Transmembrane voltage (V m) is widely acknowledged as the most important parameter during electric field stimulation of cardiac tissue, and hence we spend a significant portion of the chapter discussing the interaction between an externally applied field and isolated cell. Building on this we then discuss a slightly more complex system of a cell-pair. A coupled cell-pair is the simplest system in which the effects of intercellular gap junction on field-induced V m responses can be studied. Finally, we briefly discuss the effects of externally applied fields on intracellular Ca2+ dynamics since Ca2+is intimately linked to V m via voltage-dependent responsiveness of L-type Ca2+ channels.

New Therapies and Diagnostics, Medtronic, Inc., 8200 Coral Sea Street N.E., Minneapolis, MN 55112, USA, vinod.sharma@medtronic.com

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  1. New Therapies and Diagnostics, Medtronic Inc., Minneapolis, MN, USA

    Vinod Sharma

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  1. Vinod Sharma
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Editors and Affiliations

  1. Department of Biomedical Engineering, Washington University, St. Louis, MO, USA

    Igor R. Efimov PhD

  2. Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA

    Mark W. Kroll PhD

  3. Cleveland Clinic Foundation, Cleveland, OH

    Patrick J. Tchou MD

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Sharma, V. (2009). Mechanisms of Isolated Cell Stimulation. In: Efimov, I.R., Kroll, M.W., Tchou, P.J. (eds) Cardiac Bioelectric Therapy. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-79403-7_10

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  • DOI: https://doi.org/10.1007/978-0-387-79403-7_10

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