Periodic Conductivity as a Mechanism for Cardiac Stimulation and Defibrillation

This study examines the distribution of the transmembrane potential in the periodic strand of cardiac muscle established by configurations of sources similar to those arising during extracellular stimulation and defibrillation, during intracellular stimulation, and during propagation of action potential. The closed-form solution indicates that during extracellular stimulation with large current and during defibrillation, the periodic component of the transmembrane potential is very important. We postulate that this periodic component causes the depolarization or defibrillation in cardiac muscle, which is different from the depolarization mechanism for a continuous fiber. On the other hand, during propagation and intracellular stimulation, the periodic component only slightly modifies the monotonic decrease of the transmembrane potential, which suggests that the mechanism of propagation in discrete structures may be similar to that of the continuous fiber.