Three-dimensional aspects of re-entry in experimental and numerical models of ventricular fibrillation

Ventricular fibrillation is believed to be produced by the breakdown of re-entrant propagation waves of excitation into multiple re-entrant sources. These re-entrant waves may be idealized as spiral waves in two-dimensional, and scroll waves in three-dimensional excitable media. Optically monitored, simultaneously recorded endocardial and epicardial patterns of activation on the ventricular wall do not always show spiral waves. We show that numerical simulations, even with a simple homogeneous excitable medium, can reproduce the key features of the simultaneous endo- and epicardial visualizations of propagating activity, and so these recordings may be interpreted in terms of scroll waves within the ventricular wall.