Computational simulation of multiple wavelet re-entry and fibrillatory conduction shows differences in the ECG characteristics of each mechanism

Recent experimental and computational studies have shown that ventricular fibrillation (VF) can be sustained by either multiple wavelet re-entry, or single wavelet reentry with fibrillatory conduction in areas with slower excitation and recovery kinetics. The aim of this study was to use computational simulations to examine the possible ECG characteristics of each mechanism. Simulations were done in a 3-dimensional medium with FitzHugh Nagumo kinetics, and a pseudoECG was calculated from the sum of the excitation variable. The pseudoECG of each simulation qualitatively resembled the ECG of VF. Frequency analysis of the pseudoECGs showed a broad peak associated with dispersion of activation times in multiple re-entry, and two narrow peaks corresponding to the activation times of regions with slow and fast kinetics in the simulation fibrillatory conduction. We conclude that these mechanisms could possibly be distinguished from their surface ECG