Tunnel propagation of activation following defibrillation shocks in the rabbit heart. Arrows indicate direction of propagation. Presented is the sub- merging of a preshock fibrillatory wavefront by a strong biphasic shock delivered from an ICD. Figure shows the model, the fibrillatory preshock state (with scroll-wave filaments, the organizing centers of reentry, shown in pink), and postshock transmembrane potential maps for two shock strengths at different postshock timings. In contrast to the 25-V shock, the near-DFT 175-V shock converted the left ventricular (LV) excitable area into an intramural excitable tunnel (see triangular arrows in shock-end panel) with no apparent propagation on the epicardium; the wavefront propagated in it until epicardial breakthrough following the isoelectric window. Images based on figures published in [65].
