Contribution to the Pathogenesis of Ventricular Fibrillation: the Pre-Fibrillation Period

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Abstract
The period preceding ventricular fibrillation[long dash]the pre-fibrillation period was investigated in 43 dogs[long dash]from the metabolic, hemodynamic and electro-cardiographic stand point. Ventricular fibrillation was induced by occlusion of the descending branch of the left coronary artery and by administration of aconitin. After the administration of aconitin during the pre-fibrillation period the oxygen extraction by the myocardium is increased. During the course of the pre-fibrillation period potassium will be released from myocardial cells. Blood pressure in the left ventricle decreases to zero during this period. Systolic pressure in the right ventricle decreases with a simultaneous increase in the diastolic pressure and a consequent increase in the residual blood volume in the right ventricle. Electrocardiographic changes of the pre-fibrillation period are not uniform. This lack of uniformity is caused by a heterogeneity of causes producing ventricular fibrillation. From ventricular pressure curves as well as from the electrocardiographic tracings taken during the course of the pre-fibrillation period, it may be concluded that irregular activation of the myocardium during the pre-fibrillation period is responsible for the impairment which gradually leads to ventricular fibrillation.

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