Termination of reentry in an inhomogeneous ring of model cardiac cells.

Reentrant waves propagating in a ring or annulus of excitable media are a model of the basic mechanism underlying a major class of irregular cardiac rhythms known as anatomical reentry. Such reentrant waves are terminated by rapid electrical stimulation (pacing) from an implantable device. Because the mechanisms of such termination are poorly understood, we study pacing of anatomical reentry in a one-dimensional ring of model cardiac cells. For realistic off-circuit pacing, our model-independent results suggest that circuit inhomogeneities, and the electrophysiological dynamical changes they introduce, may be essential for terminating reentry in some cases.

[1]  A. Panfilov,et al.  Spiral breakup as a model of ventricular fibrillation. , 1998, Chaos.

[2]  David J. Christini,et al.  Critical role of inhomogeneities in pacing termination of cardiac reentry. , 2002, Chaos.

[3]  Alan Garfinkel,et al.  Spatiotemporal Chaos in a Simulated Ring of Cardiac Cells , 1997 .

[4]  A. Wear CIRCULATION , 1964, The Lancet.

[5]  L. H. Frame,et al.  Assessing the excitable gap in reentry by resetting. Implications for tachycardia termination by premature stimuli and antiarrhythmic drugs. , 1996, Circulation.

[6]  Y. Rudy,et al.  Unidirectional block and reentry of cardiac excitation: a model study. , 1990, Circulation research.

[7]  J. .. Abildskov,et al.  Mechanisms in the interruption of reentrant tachycardia by pacing. , 1995, Journal of electrocardiology.

[8]  G. G. Stokes "J." , 1890, The New Yale Book of Quotations.

[9]  J Jalife,et al.  Effects of pacing on stationary reentrant activity. Theoretical and experimental study. , 1995, Circulation research.

[10]  M. Josephson,et al.  Current status of antitachycardia devices. , 1990, Circulation.

[11]  Isthmus Characteristics of Reentrant Ventricular Tachycardia After Myocardial Infarction , 2002 .

[12]  Y Rudy,et al.  Action potential propagation in inhomogeneous cardiac tissue: safety factor considerations and ionic mechanism. , 2000, American journal of physiology. Heart and circulatory physiology.

[13]  Y Rudy,et al.  Reentry: Insights From Theoretical Simulations in a Fixed Pathway , 1995, Journal of cardiovascular electrophysiology.

[14]  Glass,et al.  Resetting and Annihilation of Reentrant Abnormally Rapid Heartbeat. , 1995, Physical review letters.

[15]  A. Kleber,et al.  Slow conduction in cardiac tissue, I: effects of a reduction of excitability versus a reduction of electrical coupling on microconduction. , 1998, Circulation research.

[16]  Y Rudy,et al.  Electrophysiologic effects of acute myocardial ischemia. A mechanistic investigation of action potential conduction and conduction failure. , 1997, Circulation research.

[17]  H. Strauss,et al.  Intracellular Potassium Activity in Rabbit Sinoatrial Node: Evaluation during Spontaneous Activity and Arrest , 1982, Circulation research.

[18]  Peter Hunter,et al.  Theory of heart , 1991 .

[19]  C. Antzelevitch,et al.  Rate‐dependent Changes in Excitability of Depressed Cardiac Purkinje Fibers as a Mechanism of Intermittent Bundle Branch Block , 1983, Circulation.

[20]  Nomura,et al.  Entrainment and termination of reentrant wave propagation in a periodically stimulated ring of excitable media. , 1996, Physical review. E, Statistical physics, plasmas, fluids, and related interdisciplinary topics.

[21]  Mark E. Josephson,et al.  Clinical cardiac electrophysiology ; techniques and interpretations , 2001 .

[22]  C. Luo,et al.  A model of the ventricular cardiac action potential. Depolarization, repolarization, and their interaction. , 1991, Circulation research.

[23]  A Garfinkel,et al.  Effects of simulated ischemia on spiral wave stability. , 2001, American journal of physiology. Heart and circulatory physiology.

[24]  S Sinha,et al.  Defibrillation via the elimination of spiral turbulence in a model for ventricular fibrillation. , 2001, Physical review letters.

[25]  P. Hogeweg,et al.  Spiral breakup in a modified FitzHugh-Nagumo model , 1993 .

[26]  A. Kleber,et al.  Electrical uncoupling and increase of extracellular resistance after induction of ischemia in isolated, arterially perfused rabbit papillary muscle. , 1987, Circulation research.

[27]  J. Keener,et al.  The effects of discrete gap junction coupling on propagation in myocardium. , 1991, Journal of theoretical biology.