Efimov Lecture - 2010-09-27Efimov: BME 140BME 140:...

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Unformatted text preview: 2010-09-27Efimov: BME 140BME 140: Introduction to Biomedical EngineeringCardiac bioelectricity: defibrillation therapy of sudden cardiac death due to ventricular fibrillation1Igor R. Efimov, Ph.D. Department of Biomedical Engineering 2010-09-27Efimov: BME 1402US Cardiovascular Disease StatisticsAmerican Heart Association, 2004The cost of cardiovascular diseases and stroke in the United States for 2007 is estimated at $431.8 billion2010-09-27Efimov: BME 140Documented sudden cardiac death3Spontaneous VF and sudden cardiac death. This figure shows a portion of a 24-h ECG recording from a patient who died a sudden cardiac death. The lines are separated by 1 minute. P.-S.Chen et al, Computerized mapping of fibrillation in normal ventricular myocardium,Chaos, 8: 127-136, 19982010-09-27Efimov: BME 1404Cardiovascular Research Pendulum: from 20thcentury reductionism to 21stcentury integration integrationreduction2010-09-27Efimov: BME 140Molecular basis of cardiac excitation and arrhythmia52010-09-27Efimov: BME 140Action potential and muscle contractionare linked via excitation-contraction coupling6-90 mV(resting potential)0 mV - - - - - - -Phase 0 1 2 3 4ICaCalcium influx into cell triggers contractionof cardiac fiber2010-09-27Efimov: BME 140Cardiac Bioelectricity72010-09-27Efimov: BME 1408Molecular basis of action potentialMarban. Nature. 2002. 2010-09-27Efimov: BME 1409Contribution of ion channels to different phases of action potentialPriori et al., Circulation, 19992010-09-27Efimov: BME 14010Diversity of ion channels: family tree of pore-forming K+ channel subunits in mammals. Priori et al., Circulation, 19992010-09-27Efimov: BME 14011Molecular basis of Long QT syndromeKeating & Sanguinetti, Cel , 20012010-09-27Efimov: BME 14012Roderick MacKinnon: 3D structure of voltage-gated potassium channel2010-09-27Efimov: BME 140Cardiac Contraction is Controlled by Electric Excitation (Action Potential)132010-09-27Efimov: BME 140Implantable Device Therapy is More Effective as compared to Pharmacologic Therapy in Treating 142010-09-27Efimov: BME 140History of cardiac bioelectricity152010-09-27Efimov: BME 140If the heart trembles, has little power and sinks, the disease is advancing and death is near the Papyrus Ebers (circa 1550 BC)16Egyptian papyrus, circa 1550 BC, discovered, translated and published by Georg Ebers as Fundamentals of the Medical Mystery, Understanding the Hearts Movement and Knowledge of the Heart Itself, 1875....
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Efimov Lecture - 2010-09-27Efimov: BME 140BME 140:...

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