Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2007
Bradycardic onset of spiral wave re-entry: structural substrates.
СтатьяПоддержка NIH: внешняя программаНазвание и аннотация: Перевод пока не подготовлен
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Zemlin Christian W, Pertsov Arkady M
Аннотация
AIMS: The least understood aspect of re-entrant cardiac arrhythmias is how they start spontaneously. The known mechanisms for re-entry induction involve the application of premature electrical stimuli or rapid pacing, whereas in a clinical setting, re-entry often occurs at normal heart rates. Here, we propose a physiological mechanism of re-entry onset at normal and slow heart rates, which is based on structurally determined heterogeneities.
METHODS AND RESULTS: Using a two-dimensional tissue model with Luo-Rudy II kinetics, we study electrical propagation in the presence of macroscopic coupling heterogeneities. We find that spiral wave re-entry occurs if steep and smooth coupling gradients are situated side by side, with the critical steepness depending on the frequency of stimulation. We demonstrate how bradycardia can unmask a slow endogenous pacemaker in a poorly coupled region, subsequently leading to spiral wave re-entry.
CONCLUSION: In the presence of coupling heterogeneities, a single excitation coming from the less coupled region may induce spiral wave re-entry.
METHODS AND RESULTS: Using a two-dimensional tissue model with Luo-Rudy II kinetics, we study electrical propagation in the presence of macroscopic coupling heterogeneities. We find that spiral wave re-entry occurs if steep and smooth coupling gradients are situated side by side, with the critical steepness depending on the frequency of stimulation. We demonstrate how bradycardia can unmask a slow endogenous pacemaker in a poorly coupled region, subsequently leading to spiral wave re-entry.
CONCLUSION: In the presence of coupling heterogeneities, a single excitation coming from the less coupled region may induce spiral wave re-entry.