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Global vs local control of cardiac alternans in a 1D numerical model of human ventricular tissue
- Source :
- Chaos (Woodbury, N.Y.). 30(8)
- Publication Year :
- 2020
-
Abstract
- Cardiac alternans is a proarrhythmic state in which the action potential duration (APD) of cardiac myocytes alternate between long and short values and often occurs under conditions of rapid pacing of cardiac tissue. In the ventricles, alternans is especially dangerous due to the life-threatening risk of developing arrhythmias, such as ventricular fibrillation. Alternans can be formed in periodically paced tissue as a result of pacing itself. Recently, it has been demonstrated that this pacing-induced alternans can be prevented by performing constant diastolic interval (DI) pacing, in which DI is independent of APD. However, constant DI pacing is difficult to implement in experimental settings since it requires the real-time measurement of APD. A more practical way was proposed based on electrocardiograms (ECGs), which give an indirect measure of the global DI relaxation period through the TR interval assessment. Previously, we demonstrated that constant TR pacing prevented alternans formation in isolated Langendorff-perfused rabbit hearts. However, the efficacy of “local” constant DI pacing vs “global” constant TR pacing in preventing alternans formation has never been investigated. Thus, the purpose of this study was to implement an ECG-based constant TR pacing in a 1D numerical model of human ventricular tissue and to compare the dynamical behavior of cardiac tissue with that resulted from a constant DI pacing. The results showed that both constant TR and constant DI pacing prevented the onset of alternans until lower basic cycle length when compared to periodic pacing. For longer cable lengths, constant TR pacing was shown to exhibit greater control on alternans than constant DI pacing.
- Subjects :
- medicine.medical_specialty
Heart Ventricles
General Physics and Astronomy
Action Potentials
01 natural sciences
010305 fluids & plasmas
Rapid pacing
Diastole
Internal medicine
0103 physical sciences
medicine
Animals
Humans
Myocytes, Cardiac
010306 general physics
Cycle length
Mathematical Physics
Ventricular tissue
business.industry
Applied Mathematics
Cardiac Pacing, Artificial
Statistical and Nonlinear Physics
Arrhythmias, Cardiac
medicine.disease
Ventricular fibrillation
cardiovascular system
Cardiology
Action potential duration
Rabbits
Diastolic interval
business
Constant (mathematics)
Subjects
Details
- ISSN :
- 10897682
- Volume :
- 30
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Chaos (Woodbury, N.Y.)
- Accession number :
- edsair.doi.dedup.....192f7163ff834b0559e633aab2c4ecf9