Open AccessThe mechanism and control of fibrillation in the mammalian heart
Publication year - 1918
Publication title -
proceedings of the royal society of london. series b, containing papers of a biological character
Language(s) - English
Resource type - Journals
eISSN - 2053-9185
pISSN - 0950-1193
DOI - 10.1098/rspb.1918.0018
Subject(s) - refractory period , beat (acoustics) , fibrillation , electrical conduction system of the heart , cardiology , cardiac muscle , ventricular fibrillation , medicine , anatomy , neuroscience , atrial fibrillation , physics , electrocardiography , psychology , acoustics
The results of the present investigation are founded on a very extended study of the subject, carried on from time to time during the past 30 years, in the course of very numerous experiments (hundreds) on the mammalian heart. These results establish the conclusion that in fibrillation there is an essential change in the manner of conduction of the excitation process in the cardiac musculature; the relation of this change to the excitability of the muscle determines the appearance and characters of the different forms of “fibrillar” action that may be observed. The conduction of the excitation is essentially altered, inasmuch as it is propagated along the muscular fibre systems or fasciculi, instead of travelling directly through the muscular substance, without obvious regard to the arrangement of the fibres, as in the normal beat of the heart. Fascicular dissociation is an essential feature of fibrillation, which is, strictly speaking, a condition of “fasciculation” rather than “fibrillation.” The essential change in conduction may be induced in very different ways. The state of fibrillation is rendered persistent by a disturbance in the normal relations of conduction time and refractory period in the cardiac musculature, resulting in the establishment of a mechanism of circulating excitations.