How Epicardial Electrodes Influence the Transmembrane Potential During a Strong Shock SALIL G. PATEL 1 and BRADLEY J. ROTH 2 1 G.W.C. School of Engineering, Johns Hopkins University, Baltimore, MD and 2 Department of Physics, Oakland University, Rochester, MI (Received 25 April 2001; accepted 2 August 2001) Abstract—This paper analyzes a possible artifact that may corrupt experiments studying defibrillation of the heart. Our hypothesis is that surface recording electrodes can influence the transmembrane potential during a shock. In the vicinity of an electrode, current leaves the intracellular space to take advan- tage of the low resistance of the extracellular path, thereby depolarizing the tissue. We calculate the transmembrane poten- tial induced around a circular electrode when exposed to a uniform electric field. The bidomain model represents the elec- trical behavior of the cardiac tissue, and we account for elec- trode polarization impedance. Our results show that adjacent regions of depolarization and hyperpolarization exist around the electrode, and that the induced depolarization is greater than 100 mV for a 0.5 mm radius silver–silver chloride electrode in a 500 V/m electric field. We conclude that surface electrodes may produce artifacts during experiments designed to study defibrillation-strength electrical shocks. © 2001 Biomedical Engineering Society. DOI: 10.1114/1.1415520 Keywords—Bidomain, Electrode, Heart, Cardiac, Shock. INTRODUCTION Many defibrillation experiments consist of shocking the heart and then recording the electrical response using epicardial surface electrodes. 1– 6,8,13,15,16,22–25,28,29 The im- plicit assumption underlying these experiments is that the recording electrodes do not influence the response of the cardiac tissue. Our hypothesis is that in some situations surface electrodes can influence the transmembrane po- tential during a defibrillation shock. If this is the case, then the act of recording the potential perturbs the elec- trical response of the heart. The response might have been different if the electrodes had not been present. The mechanism responsible for this artifact is that the epicardial electrode shorts out the extracellular space Fig. 1a. During a shock, current far from the elec- trode is distributed between the intracellular and extra- cellular spaces according to their respective conductivi- ties. However, in the vicinity of an epicardial electrode, current leaves the intracellular space to take advantage of the low resistance of the extracellular path, thereby de- polarizing the tissue. The tissue hyperpolarizes where the current reenters the tissue and redistributes back into the intracellular space. No net current passes into the elec- trode. Instead, current enters one side and exits the other, using the electrode as a low resistance shunt. One factor that influences our hypothesis is electrode polarization impedance. 19 If this impedance is large, then the electrode does not constitute a low resistance path, current does not redistribute from the intracellular to the extracellular space, and the electrode does not induce a transmembrane potential. The polarization impedance de- pends on the frequency and the electrode material. Dif- ferent research groups use different materials, including silver–silver chloride, 16,25 stainless steel, 1,13,15 and copper. 27 Also, the electrode size relative to the length constant of the tissue is important. Typical electrode di- ameters range from 250 Ref. 16to 700 m, 27 which are similar to the length constant. We model electrode polarization impedance by a parallel conductance per unit area and capacitance per unit area at the electrode– tissue interface Fig. 1b. The value for the polarization impedance is taken from the literature. 7 We consider both polarizable and nonpolarizable electrodes. METHODS We use a three-dimensional model of cardiac tissue for calculating the transmembrane potential V m and the extracellular potential V e Fig. 2. The bidomain model represents the electrical properties of the tissue 14 g ˜ e V e =- G m V m +C m V m t , 1  g ˜ i +g ˜ e V e =-g ˜ i V m , 2 where g ˜ i and g ˜ e are the intracellular and extracellular conductivity tensors g ix =g ex =0.1863, g iy =g iz Address correspondence to Brad Roth, Department of Physics, Oak- land University, 190 SEB, Rochester, MI 48309. Electronic mail: roth@oakland.edu Annals of Biomedical Engineering, Vol. 29, pp. 1028–1031, 2001 0090-6964/2001/2911/1028/4/$15.00 Printed in the USA. All rights reserved. Copyright © 2001 Biomedical Engineering Society 1028