Overdrive pacing of spiral waves in a model of human ventricular tissue

AbstractHigh-voltage electrical defibrillation remains the only reliable method of quickly controlling life-threatening cardiac arrhythmias. This paper is devoted to studying an alternative approach, low-voltage cardioversion (LVC), which is based on ideas from non-linear dynamics and aims to remove sources of cardiac arrhythmias by applying high-frequency stimulation to cardiac tissue. We perform a detailed in-silico study of the elimination of arrhythmias caused by rotating spiral waves in a TP06 model of human cardiac tissue. We consider three parameter sets with slopes of the APD restitution curve of 0.7, 1.1 and 1.4, and we study LVC at the baseline and under the blocking of INa and ICaL and under the application of the drugs verapamil and amiodarone. We show that pacing can remove spiral waves; however, its efficiency can be substantially reduced by dynamic instabilities. We classify these instabilities and show that the blocking of INa and the application of amiodarone increase the efficiency of the method, while the blocking of ICaL and the application of verapamil decrease the efficiency. We discuss the mechanisms and the possible clinical applications resulting from our study.

Download Full-text

Turbulent electrical activity at sharp-edged inexcitable obstacles in a model for human cardiac tissue

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00593.2013 ◽

2014 ◽

Vol 307 (7) ◽

pp. H1024-H1035 ◽

Cited By ~ 12

Author(s):

Rupamanjari Majumder ◽

Rahul Pandit ◽

A. V. Panfilov

Keyword(s):

Wave Propagation ◽

Cardiac Tissue ◽

Spiral Wave ◽

Spiral Waves ◽

Delayed Rectifier ◽

High Frequency Stimulation ◽

Secondary Importance ◽

Ionic Model ◽

Delayed Rectifier Current ◽

Human Cardiac Tissue

Wave propagation around various geometric expansions, structures, and obstacles in cardiac tissue may result in the formation of unidirectional block of wave propagation and the onset of reentrant arrhythmias in the heart. Therefore, we investigated the conditions under which reentrant spiral waves can be generated by high-frequency stimulation at sharp-edged obstacles in the ten Tusscher-Noble-Noble-Panfilov (TNNP) ionic model for human cardiac tissue. We show that, in a large range of parameters that account for the conductance of major inward and outward ionic currents of the model [fast inward Na+ current ( INa), L—type slow inward Ca2+ current ( ICaL), slow delayed-rectifier current ( IKs), rapid delayed-rectifier current ( IKr), inward rectifier K+ current ( IK1)], the critical period necessary for spiral formation is close to the period of a spiral wave rotating in the same tissue. We also show that there is a minimal size of the obstacle for which formation of spirals is possible; this size is ∼2.5 cm and decreases with a decrease in the excitability of cardiac tissue. We show that other factors, such as the obstacle thickness and direction of wave propagation in relation to the obstacle, are of secondary importance and affect the conditions for spiral wave initiation only slightly. We also perform studies for obstacle shapes derived from experimental measurements of infarction scars and show that the formation of spiral waves there is facilitated by tissue remodeling around it. Overall, we demonstrate that the formation of reentrant sources around inexcitable obstacles is a potential mechanism for the onset of cardiac arrhythmias in the presence of a fast heart rate.

Download Full-text

Effects of High Frequency Stimulation on Cardiac Tissue with an Inexcitable Obstacle

Journal of Theoretical Biology ◽

10.1006/jtbi.1993.1129 ◽

1993 ◽

Vol 163 (4) ◽

pp. 439-448 ◽

Cited By ~ 48

Author(s):

Alexander V. Panfilov ◽

James P. Keener

Keyword(s):

High Frequency ◽

Cardiac Tissue ◽

High Frequency Stimulation ◽

Frequency Stimulation

Download Full-text

SPIRAL FORMATION IN A BELOUSOV-ZHABOTINSKY MEDIUM BY PREMATURE RE-EXCITATION: VULNERABILITY

International Journal of Bifurcation and Chaos ◽

10.1142/s0218127494000897 ◽

1994 ◽

Vol 04 (05) ◽

pp. 1193-1204 ◽

Cited By ~ 4

Author(s):

M. GÓMEZ-GESTEIRA ◽

G. FERNÁNDEZ-GARCÍA ◽

A.P. MUÑUZURI ◽

V. PÉREZ-MUÑUZURI ◽

V.I. KRINSKY ◽

...

Keyword(s):

Cardiac Tissue ◽

Conditioning Stimulus ◽

Heart Rhythm ◽

Critical Value ◽

Spiral Waves ◽

Spatial Extent ◽

The Third ◽

Isotropic Diffusion ◽

Life Threatening ◽

Third Dimension

Spiral waves can be initiated in cardiac tissue by first stimulating it with a conditioning stimulus and then by a test stimulus at a different site. Because the resulting heart rhythm can be life threatening, this behaviour has been widely treated and the interval of time between conditioning and test stimuli has been labelled vulnerability. We hypothesize that the anisotropic cardiac structure was not essential for spiral initiation and reproduced it in a Belousov-Zhabotinsky (BZ) medium, which is continuous and characterized by isotropic diffusion coefficients. We observe that the different spatial extent of the medium (systems “quasi” 1D, 2D or 3D) influences the evolution of the test wave front. Even when the spatial extent of the third dimension exceeds a critical value, the region of vulnerability can disappear.

Download Full-text

Carbon Monoxide Effect on Human Cardiac Tissue. In Silico Study

10.1007/978-3-030-86702-7_14 ◽

2021 ◽

pp. 160-170

Author(s):

Catalina Tobón ◽

Geraldine Durango-Giraldo ◽

Juan Pablo Ugarte

Keyword(s):

Carbon Monoxide ◽

In Silico ◽

Cardiac Tissue ◽

In Silico Study ◽

Human Cardiac Tissue

Download Full-text

Respiratory and blood pressure responses to stimulation of peripheral afferent nerves

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1965.208.5.993 ◽

1965 ◽

Vol 208 (5) ◽

pp. 993-999 ◽

Cited By ~ 10

Author(s):

S. Katz ◽

J. H. Perryman

Keyword(s):

Blood Pressure ◽

Peripheral Nerve ◽

High Voltage ◽

High Frequency ◽

Low Voltage ◽

Low Frequency ◽

Minute Volume ◽

High Frequency Stimulation ◽

Frequency Stimulation ◽

Stimulation Of

Experiments on cats anesthetized with pentobarbital sodium indicate that a change in the frequency of peripheral nerve stimulation will alter the direction of the blood pressure and respiratory response only after a certain intensity of stimulation is attained. Low voltage-high frequency (1–3 v, 60/sec), high voltage-low frequency (15 v, 10/sec) and low voltage-low frequency stimulation of the tibial and/or peroneal nerves initially produces a decrease in blood pressure (20–50 mm Hg) and a decrease in respiratory minute volume (13–92%). However, high voltage-high frequency stimulation generally produces an increase in blood pressure of 10–65 mm Hg and an 8–14% increase in minute volume. In decerebrate cats, low-voltage, high-frequency as well as high-voltage, high-frequency stimulation of the tibial nerve results in an increase in blood pressure, minute volume, and/or rate and amplitude of phrenic nerve discharge. Frequency and intensity are therefore interrelated. Anatomical specificity of limb peripheral nerve fibers into pressor and depressor afferents is not substantiated.

Download Full-text

Induced drift of scroll waves in the Aliev–Panfilov model and in an axisymmetric heart left ventricle

Russian Journal of Numerical Analysis and Mathematical Modelling ◽

10.1515/rnam-2020-0023 ◽

2020 ◽

Vol 35 (5) ◽

pp. 273-283 ◽

Cited By ~ 1

Author(s):

Sergei F. Pravdin ◽

Timofei I. Epanchintsev ◽

Timur V. Nezlobinskii ◽

Alexander V. Panfilov

Keyword(s):

Left Ventricle ◽

Low Voltage ◽

Three Dimensional ◽

Spiral Wave ◽

Spiral Waves ◽

High Frequency Stimulation ◽

Two Dimensional ◽

Anatomical Model ◽

Paroxysmal Tachycardia ◽

Scroll Waves

AbstractThe low-voltage cardioversion-defibrillation is a modern sparing electrotherapy method for such dangerous heart arrhythmias as paroxysmal tachycardia and fibrillation. In an excitable medium, such arrhythmias relate to appearance of spiral waves of electrical excitation, and the spiral waves are superseded to the electric boundary of the medium in the process of treatment due to high-frequency stimulation from the electrode. In this paper we consider the Aliev–Panfilov myocardial model, which provides a positive tension of three-dimensional scroll waves, and an axisymmetric model of the left ventricle of the human heart. Two relations of anisotropy are considered, namely, isotropy and physiological anisotropy. The periods of stimulation with an apical electrode are found so that the electrode successfully entrains its rhythm in the medium, the spiral wave is superseded to the base of the ventricle, and disappears. The results are compared in two-dimensional and three-dimensional media. The intervals of effective stimulation periods are sufficiently close to each other in the two-dimensional case and in the anatomical model. However, the use of the anatomical model is essential in determination of the time of superseding.

Download Full-text