The effect of vagally induced dispersion of action potential duration on atrial arrhythmogenesis

被引:64
|
作者
Vigmond, EJ
Tsoi, V
Kuo, S
Arevalo, H
Kneller, J
Nattel, S
Trayanova, N
机构
[1] Univ Calgary, Dept Elect & Comp Engn, Calgary, AB T2N 1N4, Canada
[2] Tulane Univ, Dept Biomed Engn, New Orleans, LA 70118 USA
[3] Univ Montreal, Montreal, PQ, Canada
[4] Montreal Heart Inst, Dept Med, Montreal, PQ H1T 1C8, Canada
基金
加拿大健康研究院;
关键词
atrial structure; reentry; vagal stimulation; atrial model;
D O I
10.1016/j.hrthm.2004.03.077
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVE The purpose of this study is to ascertain the effects of spatially variable ACh distributions on arrhythmogenesis in a morphologically realistic computer model of canine atria. BACKGROUND Vagal stimulation releases acetylcholine (ACh), which causes a dose-dependent reduction in action potential duration (APD) in the atria. Due to the nonuniform distribution of nerve endings, APD dispersion may result, which has been shown to play a role in the breakup of activity. METHODS Reentry was initiated in a computationally efficient, morphologically realistic computer model of the atria. Discrete regions corresponding to ACh release sites, referred to as islands, were assigned shortened APDs in an ACh-dependent fashion. Island APD was varied as well as the basal APD. The window of vulnerability for ectopic beat-induction of sustained reentry was determined for both left atrial(LA) and right atrial (RA) stimulation. The resulting reentries were categorized based on type and location. RESULTS 1) Atrial geometry severely restricts the formation of reentrant circuits. 2) Wave fractionation only occurred for large differences between island and basal APD. 3) Small ACh concentration differences produced stable figure-of-8 reentrant patterns. 4) Large islands displayed more wave breakup but could sometimes anchor reentries. CONCLUSIONS Large APD gradients produced by ACh heterogeneity can lead to a breakdown of organized activity.
引用
收藏
页码:334 / 344
页数:11
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