Ventricular tachycardia induced by antitachycardia pacing for ventricular tachycardia: Not so pain-free?

Double-wave reentry in excitable media

A monolayer of chick embryo cardiac cells grown in an annular geometry supports two simultaneous reentrant excitation waves that circulate as a doublet. We propose a mechanism that can lead to such behavior. The velocity restitution gives the instantaneous velocity of a wave as a function of the time since the passage of the previous wave at a given point in space. Nonmonotonic restitution relationships will lead to situations in which various spacings between circulating waves are possible. In cardiology, the situation in which two waves travel in an anatomically defined circuit is referred to as double-wave reentry. Since double-wave reentry may arise as a consequence of pacing during cardiac arrhythmias, understanding the dynamic features of double-wave reentry may be helpful in understanding the physiological properties of cardiac tissue and in the design of therapy.