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Virtual Electrode Effects in Transvenous Defibrillation‐Modulation by Structure and Interface: Evidence from Bidomain Simulations and Optical Mapping

Virtual Electrodes, Bidomain Model, and Defibrillation. Introduction: Our goal in this combined modeling and experimental study was to gain insight into the transmembrane potential changes in defibrillation conditions, namely, when shocks are delivered by an implantable cardioverter defibrillator (ICD). Two hypotheses concerning the presence and characteristics of virtual electrode effects (VEE) during an ICD shock were tested numerically and experimentally: (H1) anisotropy‐dependent VEE are induced over a considerable portion of the “bulk” myocardium; and (H2) surface (epicardial and endocardial) VEE are generated under special tissue bath conditions and are not fully anisotropy determined.