Constant DI pacing suppresses cardiac alternans formation in numerical cable models

Zlochiver, S.; Johnson, C.; Tolkacheva, E. G.
September 2017
Chaos;2017, Vol. 27 Issue 9, p1
Academic Journal
Cardiac repolarization alternans describe the sequential alternation of the action potential duration (APD) and can develop during rapid pacing. In the ventricles, such alternans may rapidly turn into life risking arrhythmias under conditions of spatial heterogeneity. Thus, suppression of alternans by artificial pacing protocols, or alternans control, has been the subject of numerous theoretical, numerical, and experimental studies. Yet, previous attempts that were inspired by chaos control theories were successful only for a short spatial extent (<2 cm) from the pacing electrode. Previously, we demonstrated in a single cell model that pacing with a constant diastolic interval (DI) can suppress the formation of alternans at high rates of activation. We attributed this effect to the elimination of feedback between the pacing cycle length and the last APD, effectively preventing restitution-dependent alternans from developing. Here, we extend this idea into cable models to study the extent by which constant DI pacing can control alternans during wave propagation conditions. Constant DI pacing was applied to ventricular cable models of up to 5 cm, using human kinetics. Our results show that constant DI pacing significantly shifts the onset of both cardiac alternans and conduction blocks to higher pacing rates in comparison to pacing with constant cycle length. We also demonstrate that constant DI pacing reduces the propensity of spatially discordant alternans, a precursor of wavebreaks. We finally found that the protective effect of constant DI pacing is stronger for increased electrotonic coupling along the fiber in the sense that the onset of alternans is further shifted to higher activation rates. Overall, these results support the potential clinical applicability of such type of pacing in improving protocols of implanted pacemakers, in order to reduce the risk of life-threatening arrhythmias. Future research should be conducted in order to experimentally validate these promising results.


Related Articles

  • Regional differences in APD restitution can initiate wavebreak and re-entry in cardiac tissue: A computational study. Clayton, Richard H; Taggart, Peter // BioMedical Engineering OnLine;2005, Vol. 4, p54 

    Background: Regional differences in action potential duration (APD) restitution in the heart favour arrhythmias, but the mechanism is not well understood. Methods: We simulated a 150 × 150 mm 2D sheet of cardiac ventricular tissue using a simplified computational model. We investigated...

  • Al3+ induced membrane potential changes in Nitellopsis obtusa cells. Kisnierienë, V.; Sakalauskas, V. // Biologija;2005, Issue 1, p31 

    To study the mechanism of aluminium toxicity in plant cells, the effects of aluminium on the electrogenesis of plasma membrane were investigated. We analyzed Al 3+ induced membrane potential (E m ) changes and potential changes during generation of the action potential (AP) in the internodal...

  • Predicting the activity phase of a follower neuron with A-current in an inhibitory network. Zhang, Yu; Bose, Amitabha; Nadim, Farzan // Biological Cybernetics;Sep2008, Vol. 99 Issue 3, p171 

    The transient potassium A-current is present in most neurons and plays an important role in determining the timing of action potentials. We examine the role of the A-current in the activity phase of a follower neuron in a rhythmic feed-forward inhibitory network with a reduced three-variable...

  • Possible arrhythmiogenic mechanism produced by ibuprofen. Zhi-fang Yang; Hong-wei Wang; Yan-qian Zheng; Yin Zhang; Yuan-mou Liu; Ci-zhen Li // Acta Pharmacologica Sinica;Apr2008, Vol. 29 Issue 4, p421 

    Aim: The aim of the present study was to investigate the electrophysiological effect of ibuprofen on the cardiac action potentials (AP) and electrocardiograms (ECG), and to identify its arrhythmiogenic mechanism. Methods: The intracellular microelectrode recording technique was employed to...

  • Atrial effects of the novel K+-channel-blocker AVE0118 in anesthetized pigs. Wirth, Klaus J.; Paehler, Tobias; Rosenstein, Bjoern; Knobloch, Karsten; Maier, Thomas; Frenzel, Jennifer; Brendel, Joachim; Busch, Andreas E.; Bleich, Markus // Cardiovascular Research;Nov2003, Vol. 60 Issue 2, p298 

    Objectives: AVE0118 is a novel blocker of the K+ channels Kv1.5 and Kv4.3 which are the molecular basis for the human cardiac ultrarapid delayed rectifier potassium current (IKur) and the transient outward current (Ito). The objective of this study was to investigate the effect of AVE0118 on...

  • Electrophysiologic Characteristics of the Crista Terminalis and Implications on Atrial Tachycardia in Rabbits. Li-jun, Jin; Xue-yin, Liu; Cong-xin, Huang; Bo, Yang; Sha-ning, Yang; Gang, Wu; Qiang, Xie; Huang-jun, Liu // Cell Biochemistry & Biophysics;Mar2012, Vol. 62 Issue 2, p267 

    The objective of this study was to evaluate the electrophysiologic characteristics of Crista terminalis (CT) and their implication in the pathogenesis of atrial tachycardia in rabbits. For this purpose, 27 New Zealand rabbits were used. Using standard glass microelectrode technique, cellular...

  • Current Perspectives of Electrical Remodeling and Its Therapeutic Implications. Sanjeev Wasson; Reddy, K.; Dohrmann, Mary L. // Journal of Cardiovascular Pharmacology & Therapeutics;Jun2004, Vol. 9 Issue 2, p129 

    This article focuses on the therapeutic implications of electrical remodeling. Many disease states affect the cardiac electrophysiologic milieu; in addition, cardiac arrhythmias can lead to an alteration of the structure and function of the heart, which in turn can cause or exacerbate the...

  • In-silico modeling of atrial repolarization in normal and atrial fibrillation remodeled state. Krueger, Martin; Dorn, Andreas; Keller, David; Holmqvist, Fredrik; Carlson, Jonas; Platonov, Pyotr; Rhode, Kawal; Razavi, Reza; Seemann, Gunnar; Dössel, Olaf // Medical & Biological Engineering & Computing;Oct2013, Vol. 51 Issue 10, p1105 

    Atrial fibrillation (AF) is the most common cardiac arrhythmia, and the total number of AF patients is constantly increasing. The mechanisms leading to and sustaining AF are not completely understood yet. Heterogeneities in atrial electrophysiology seem to play an important role in this context....

  • P108 Two sides of the same coin: integrative role of the calcium-activated chloride channels in the ventricular myocardium. Hegyi, B; Vaczi, K; Ruzsnavszky, F; Kistamas, K; Gonczi, M; Horvath, B; Banyasz, T; Magyar, J; Nanasi, P; Szentandrassy, N // Cardiovascular Research;Jul2014, Vol. 103 Issue suppl_1, pS18 

    As a part of the transient outward current, the calcium-activated chloride current (ICl(Ca)) is involved in the action potential (AP) repolarization, however, its possible contribution to formation of delayed afterdepolarizations and thus life threatening arrhythmias was also suggested,...

  • Dispersion of cardiac action potential duration and the initiation of re-entry: A computational study. Clayton, Richard H; Holden, Arun V // BioMedical Engineering OnLine;2005, Vol. 4, p11 

    Background: The initiation of re-entrant cardiac arrhythmias is associated with increased dispersion of repolarisation, but the details are difficult to investigate either experimentally or clinically. We used a computational model of cardiac tissue to study systematically the association...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics