Phase 2 Re-Entry Without Ito: Role of Sodium Channel Kinetics in Brugada Syndrome Arrhythmias

Bistable spiral wave dynamics in electrically excitable media

We show that a positive feedback loop between sodium current inactivation and wave-front ramp-up speed causes a saddle-node bifurcation to result in bistable planar and spiral waves in electrically excitable media, in which both slow and fast waves are triggered by different stimulation protocols. Moreover, the two types of spiral wave conduction may interact to give rise to more complex spiral wave dynamics. The transitions between different spiral wave behaviors via saddle-node bifurcation can be a candidate mechanism for transitions widely seen in cardiac arrhythmias and neural diseases.