Left to Right Atrial Electrophysiological Differences: Substrate for a Dominant Reentrant Source during Atrial Fibrillation

Experimentally observed differences in the action potential (AP) properties --- primarily, refractoriness --- between the left (LA) and right (RA) atria are believed to be important in maintaining atrial fibrillation. We incorporate AP models for single LA and RA cells into 2D atrial tissue models and study the role of tissue heterogeneity in global interaction between reentrant spiral waves in the LA and RA. Our simulations show that shorter refractoriness in the LA translates into a shorter period of spiral rotation, and as a result, reentry in the LA dominates the overall excitation patterns in the atria.

[1]  J A ABILDSKOV,et al.  Atrial fibrillation as a self-sustaining arrhythmia independent of focal discharge. , 1959, American heart journal.

[2]  V. Krinsky,et al.  Interaction of rotating waves in an active chemical medium , 1983 .

[3]  M S Spach,et al.  Interaction of Inhomogeneities of Repolarization With Anisotropic Propagation in Dog Atria: Mechanism for Both Preventing and Initiating Reentry , 1989, Circulation research.

[4]  H. Inoue,et al.  Role of anatomic architecture in sustained atrial reentry and double potentials. , 1992, American heart journal.

[5]  C R Kerr,et al.  Regional differences in rabbit atrial repolarization: importance of transient outward current. , 1994, The American journal of physiology.

[6]  A. Harada,et al.  Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease. , 1996, The Annals of thoracic surgery.

[7]  E J Berbari,et al.  Epicardial Maps of Atrial Fibrillation After Linear Ablation Lesions , 1997, Journal of cardiovascular electrophysiology.

[8]  R. Gray,et al.  Spatial and temporal organization during cardiac fibrillation , 1998, Nature.

[9]  S Nattel,et al.  Ionic mechanisms of regional action potential heterogeneity in the canine right atrium. , 1998, Circulation research.

[10]  J Clémenty,et al.  Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. , 1998, The New England journal of medicine.

[11]  Alan Garfinkel,et al.  INTERACTIONS BETWEEN STABLE SPIRAL WAVES WITH DIFFERENT FREQUENCIES IN CARDIAC TISSUE , 1999 .

[12]  M. Lesh,et al.  Electrophysiologic Effects of Selective Right versus Left Atrial Linear Lesions in a Canine Model of Chronic Atrial Fibrillation , 1999, Journal of cardiovascular electrophysiology.

[13]  J Jalife,et al.  Stable microreentrant sources as a mechanism of atrial fibrillation in the isolated sheep heart. , 2000, Circulation.

[14]  S Nattel,et al.  Basic mechanisms of atrial fibrillation--very new insights into very old ideas. , 2000, Annual review of physiology.

[15]  S Nattel,et al.  Potential Ionic Mechanism for Repolarization Differences Between Canine Right and Left Atrium , 2001, Circulation research.

[16]  Craig S. Henriquez,et al.  Interplay of ionic and structural heterogeneity on functional action potential duration gradients: Implications for arrhythmogenesis. , 2002, Chaos.

[17]  M. Mansour,et al.  Mother rotors and fibrillatory conduction: a mechanism of atrial fibrillation. , 2002, Cardiovascular research.

[18]  Ruben Coronel,et al.  Conduction slowing by the gap junctional uncoupler carbenoxolone. , 2003, Cardiovascular research.

[19]  Takashi Nitta,et al.  Interatrial Electrical Connections: The Precise Location and Preferential Conduction , 2005, Journal of cardiovascular electrophysiology.

[20]  H Honjo,et al.  Computer Three-Dimensional Reconstruction of the Sinoatrial Node , 2005, Circulation.

[21]  Natalia A Trayanova,et al.  Action potential morphology heterogeneity in the atrium and its effect on atrial reentry: a two-dimensional and quasi-three-dimensional study , 2006, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[22]  A. Holden,et al.  Heterogeneous three-dimensional anatomical and electrophysiological model of human atria , 2006, Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences.

[23]  José Jalife,et al.  Reentry and atrial fibrillation. , 2007, Heart rhythm.

[24]  P. Platonov,et al.  Interatrial conduction in the mechanisms of atrial fibrillation: from anatomy to cardiac signals and new treatment modalities. , 2007, 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.

[25]  Henggui Zhang,et al.  Regional differences in rabbit atrial action potential properties: Mechanisms, consequences and pharmacological implications , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[26]  Henggui Zhang,et al.  The canine virtual ventricular wall: a platform for dissecting pharmacological effects on propagation and arrhythmogenesis. , 2008, Progress in biophysics and molecular biology.

[27]  Henggui Zhang,et al.  Mechanisms of transition from normal to reentrant electrical activity in a model of rabbit atrial tissue: interaction of tissue heterogeneity and anisotropy. , 2009, Biophysical journal.