Abstract
Spiral waves can be most commonly observed in structurally and electrophysiologically normal hearts during tachyarrhythmia, such as ventricular fibrillation. Electrocardiograms obtained during tachyarrhythmia can be very helpful in understanding the mechanism of this disease because the morphological variations they demonstrate can reflect the characteristics of spiral wave dynamics. A comparison of electrocardiograms obtained in computer simulations and those from actual clinical cases, showed that the important substrates of the mechanism of ventricular fibrillation are spiral wave meandering and breakup, resulting from the restitution property of action potential duration, wall thickness, twisted anisotropy, complex boundary, and so on. In some cases, the frequency spectrum of the electrocardiograms may prove useful in predicting the occurrence of spiral wave breakup and to understand the role of the substrate in the composition of the characteristic complex waveforms. In conclusion, the discrimination between ventricular tachycardia and ventricular fibrillation can be quite difficult due to the vague differences in the wave dynamics in the background.
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