Cardiac beat-to-beat alternations driven by unusual spiral waves

Proc Natl Acad Sci U S A. 2007 Jul 10;104(28):11639-42. doi: 10.1073/pnas.0704204104. Epub 2007 Jul 2.

Abstract

Alternans, a beat-to-beat temporal alternation in the sequence of heartbeats, is a known precursor of the development of cardiac fibrillation, leading to sudden cardiac death. The equally important precursor of cardiac arrhythmias is the rotating spiral wave of electro-mechanical activity, or reentry, on the heart tissue. Here, we show that these two seemingly different phenomena can have a remarkable relationship. In well controlled in vitro tissue cultures, isotropic populations of rat ventricular myocytes sustaining a temporal rhythm of alternans can support period-2 oscillatory reentries and vice versa. These reentries bear "line defects" across which the phase of local excitation slips rather abruptly by 2pi, when a full period-2 cycle of alternans completes in 4pi. In other words, the cells belonging to the line defects are period-1 oscillatory, whereas all of the others in the bulk medium are period-2 oscillatory. We also find that a slowly rotating line defect results in a quasi-periodic like oscillation in the bulk medium. Some key features of these phenomena can be well reproduced in computer simulations of a nonlinear reaction-diffusion model.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Animals
  • Cells, Cultured
  • Computer Simulation
  • Diffusion
  • Heart Rate / physiology*
  • Heart Ventricles / cytology
  • Models, Cardiovascular*
  • Myocardial Contraction / physiology*
  • Rats
  • Ventricular Function