Effect of resistive barrier location on the relationship between T-wave alternans and cellular repolarization alternans: a 1-D modeling study |
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Authors: | Doshi Ashish N Idriss Salim F |
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Affiliation: | a Department of Biomedical Engineering, Duke University, Durham, NCb Division of Pediatric Cardiology, Department of Pediatrics, Duke University Medical Center, Durham, NC |
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Abstract: | Structural inhomogeneities in cardiac tissue have been associated with increased cellular repolarization alternans in animal experiments and increased T-wave alternans (TWA) in clinical studies. However, the effect of structural inhomogeneities on the relationship between cellular alternans and TWA has not been thoroughly investigated. We created 1-dimensional multicellular fiber models with and without a resistive barrier in various fiber regions and paced each model to induce cellular alternans. The models demonstrate that a resistive barrier in one fiber region substantially alters cellular repolarization alternans throughout the fiber. A midmyocardial or subepicardial barrier increase both TWA amplitude and maximum cellular alternans magnitude, relative to a fiber without a barrier. In addition, a direct relationship exists between TWA amplitude and maximum cellular alternans magnitude, which was highly dependent on barrier location. These results suggest that the position of a structural inhomogeneity within the myocardium may have substantial effects on dynamic repolarization instability and arrhythmogenicity. |
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Keywords: | Conductivity Gap junction Connexin |
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