Study of Peak-to-Peak Amplitude Distribution in Cardiac Rhythms: Electrophysiological Mapping in Langendorff-Perfused Rabbit Hearts

Jose Carlos Gomes Junior1, Jimena Gabriela Siles Paredes2, Tainan Cerqueira Neves3, Angélica Drielly Quadros4, Saleem Ullah5, Vinicius de Paula Silva1, Joao Salinet6
1Universidade Federal do ABC, 2Graduate Program in Biotechnoscience, Federal University of ABC, 3Federal University of ABC, 4UFABC, 5Center for Engineering, modelling and applied social sciences (CECS), Federal University of ABC (UFABC), 6HEartLab, Federal University of ABC


Abstract

Introduction: Cardiac arrhythmias, driven by complex electrophysiological substrates, remain a major clinical challenge. This study characterized peak-to-peak voltage amplitudes across epicardial regions (right atrium [RA], left atrium [LA], ventricle [V]) in Langendorff-perfused rabbit hearts during sinus rhythm (SR), atrial tachycardia (AT), ventricular fibrillation (VF), and SR with atrioventricular block (AVB). Methods: 6 New Zealand rabbits (3.44±0.36 kg) were used in this study. The hearts were perfused in a Langendorff system with modified Krebs-Henseleit solution (37.5-38°C, bubbled with carbogen) under constant pressure (70-80 mmHg), with contractility suppression by (-)-blebbistatin (1.7 μM). To obtain different heart rhythms, arrhythmias were induced via programmed stimulation protocols (S1-S1/S1-S2) and carbachol perfusion (1 μM). Unipolar contact epicardial electrograms were acquired using silver and silver/iridium microelectrode arrays (MEAs), processed via notch (60 Hz) and bandpass (2–250 Hz) filtering. Results: A total of 8 recordings ranging from 15 seconds were analyzed. During SR, mean peak-to-peak amplitudes were 10.91±9.21 mV (RA), 15.20 ±7.53 mV (LA), and 13.64±8.07 mV (V), with 95th percentile cutoffs for healthy tissue up to at 3.89 mV (RA), 8.25 mV (LA), and 4.54 mV (V). Arrhythmias exhibited distinct amplitude patterns: AT preserved RA voltages (7.31±3.36 mV vs. SR: 8.55±2.26 mV) but increased V signals (26.2±6.72 mV vs. 21.4±6.57 mV), while VF caused marked reductions (e.g., VF: V= 0.83±0.46 mV), reflecting electrical disorganization. Silver/iridium electrodes yielded 68% higher amplitudes than pure silver (LA: 22.89±5.78 mV vs. 13.64±8.08 mV), underscoring material-dependent signal fidelity. High variability (e.g., RA: ±9.21 mV) likely stemmed from uneven electrode-tissue contact and perfusion artifacts. Conclusions: This study characterized epicardial voltage amplitudes across multiple cardiac rhythms in a Langendorff-perfused rabbit model, revealing distinct electrophysiological patterns: preserved atrial amplitudes during AT, marked reductions during VF, and enhanced ventricular signals during AT, consistent with arrhythmia-specific electrical desynchrony.