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Related Experiment Videos

Mechanisms for discordant alternans.

M A Watanabe1, F H Fenton, S J Evans

  • 1Physics Department, Northeastern University, Boston, Massachusetts 02115, USA.

Journal of Cardiovascular Electrophysiology
|March 10, 2001
PubMed
Summary

Discordant alternans can arise spontaneously in heart tissue without spatial variations. Simulations reveal two mechanisms involving pacing frequency or ectopic beats, challenging previous assumptions about cardiac electrical behavior.

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Area of Science:

  • Cardiac electrophysiology
  • Computational modeling of biological systems
  • Heart rhythm disorders

Background:

  • Discordant alternans can cause larger T-wave alternations than concordant alternans.
  • The underlying mechanisms driving discordant alternans remain largely unknown.
  • Understanding these mechanisms is crucial for diagnosing and treating cardiac arrhythmias.

Purpose of the Study:

  • To investigate the mechanisms responsible for the spontaneous formation of discordant alternans.
  • To determine if spatial inhomogeneities in electrical restitution are necessary for discordant alternans.
  • To elucidate the role of tissue properties and pacing in alternans formation.

Main Methods:

  • One- and two-dimensional simulations of action potential propagation models were employed.

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  • Analysis focused on the interaction between conduction velocity and action potential duration restitution.
  • The influence of ectopic foci and electrotonic coupling was examined.

    • Main Results:

    • Discordant alternans can form spontaneously in spatially homogeneous tissue via two distinct mechanisms.
    • Mechanism 1 involves the interplay of conduction velocity and action potential duration restitution at high pacing rates.
    • Mechanism 2 involves diastolic interval dispersion from ectopic foci; dynamic splitting of restitution curves stabilizes alternans.

    Conclusions:

    • Spatial inhomogeneities in electrical restitution properties are not a prerequisite for discordant alternans.
    • The findings challenge the necessity of tissue heterogeneity for the development of discordant alternans.
    • This study provides novel insights into the spontaneous generation of complex cardiac electrical phenomena.