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It is believed that shock-induced intramural virtual electrodes (IVE) play a critical role in defibrillation. IVE were recently demonstrated in the porcine left ventricle (LV), but their origin remains unknown. Macroscopic optical mapping showed that strong shocks induce IVE of only one polarity, which contradicts theoretical predictions. It is hypothesized that IVE have a microscopic origin and that microscopic positive and negative IVE are spatially averaged during macroscopic optical mapping. This hypothesis was examined by mapping V(m) responses at the transmural LV surface with increased optical resolution.

High-resolution optical mapping of intramural virtual electrodes in porcine left ventricular wall