Self-organization and the dynamical nature of ventricular fibrillation

Scroll Waves and Filaments in Excitable Media of Higher Spatial Dimension

Excitable media are ubiquitous in nature, and in such systems the local excitation tends to self-organize in traveling waves, or in rotating spiral-shaped patterns in two or three spatial dimensions. Examples include waves during a pandemic or electrical scroll waves in the heart. Here we show that such phenomena can be extended to a space of four or more dimensions and propose that connections of excitable elements in a network setting can be regarded as additional spatial dimensions. Numerical simulations are performed in four dimensions using the FitzHugh-Nagumo model, showing that the vortices rotate around a two-dimensional surface which we define as the superfilament. Evolution equations are derived for general superfilaments of codimension two in an N-dimensional space, and their equilibrium configurations are proven to be minimal surfaces. We suggest that biological excitable systems, such as the heart or brain which have nonlocal connections can be regarded, at least partially, as multidimensional excitable media and discuss further possible studies in this direction.

Amiodarone prevents wave front-tail interactions in patients with heart failure: an in silico study

Amiodarone (AM) is an antiarrhythmic drug whose chronic use has proved effective in preventing ventricular arrhythmias in a variety of patient populations, including those with heart failure (HF). AM has both class III [i.e., it prolongs the action potential duration (APD) via blocking potassium channels) and class I (i.e., it affects the rapid sodium channel) properties; however, the specific mechanism(s) by which it prevents reentry formation in patients with HF remains unknown. We tested the hypothesis that AM prevents reentry induction in HF during programmed electrical stimulation (PES) via its ability to induce postrepolarization refractoriness (PRR) via its class I effects on sodium channels. Here we extend our previous human action potential model to represent the effects of both HF and AM separately by calibrating to human tissue and clinical PES data, respectively. We then combine these models (HF + AM) to test our hypothesis. Results from simulations in cells and cables suggest that AM acts to increase PRR and decrease the elevation of takeoff potential. The ability of AM to prevent reentry was studied in silico in two-dimensional sheets in which a variety of APD gradients (ΔAPD) were imposed. Reentrant activity was induced in all HF simulations but was prevented in 23 of 24 HF + AM models. Eliminating the AM-induced slowing of the recovery of inactivation of the sodium channel restored the ability to induce reentry. In conclusion, in silico testing suggests that chronic AM treatment prevents reentry induction in patients with HF during PES via its class I effect to induce PRR.NEW & NOTEWORTHY This work presents a new model of the action potential of the human, which reproduces the complex dynamics during premature stimulation in heart failure patients with and without amiodarone. A specific mechanism of the ability of amiodarone to prevent reentrant arrhythmias is presented.

Aging transition in coupled quantum oscillators

Aging transition is an emergent behavior observed in networks consisting of active (self-oscillatory) and inactive (non-self-oscillatory) nodes, where the network transits from a global oscillatory state to an oscillation collapsed state when the fraction of inactive oscillators surpasses a critical value. However, the aging transition in quantum domain has not been studied yet. In this paper we investigate the quantum manifestation of aging transition in a network of active-inactive quantum oscillators. We show that, unlike classical case, the quantum aging is not characterized by a complete collapse of oscillation but by sufficient reduction in the mean boson number. We identify a critical "knee" value in the fraction of inactive oscillators around which quantum aging occurs in two different ways. Further, in stark contrast to the classical case, quantum aging transition depends upon the nonlinear damping parameter. We also explain the underlying processes leading to quantum aging that have no counterpart in the classical domain.

Rotational synchronization of pinned spiral waves

Coupled rotors can spontaneously synchronize, giving rise to a plethora of intriguing dynamics. We present here a pair of spiral waves as two synchronizing rotors, coupled by diffusion. The spirals are pinned to unexcitable obstacles, which enables us to modify their frequencies and restrain their drift. In experiments with the Belousov-Zhabotinsky reaction, we show that two counterrotating spiral rotors, pinned to circular heterogeneities, can synchronize in frequency and phase. The nature of the phase synchronization varies depending on the difference in their characteristic frequencies. We observe in-phase and out-of-phase synchronization, lag synchronization, and phase resetting across the experiments. The time required for the two spirals to synchronize is found to depend upon the relative size of their pinning obstacles and the distance separating them. This distance can also modify the phase lag of the two rotors upon synchronization. Our experimental observations are reproduced and explained further on the basis of numerical simulations of an excitable reaction-diffusion model.

Interaction of multiple spiral rotors in a reaction-diffusion system

Rotors of reaction and diffusion are phase singularities that give rise to spiral waves of chemical activity, which are very similar to spatiotemporal patterns observed across several excitable media. Here we carry out experiments with the Belousov-Zhabotinsky reaction system and numerical simulations based on a reaction-diffusion model to show the possible interactions of multiple spiral rotors. When the cores of two spirals come very close to each other, they could either repel, attract, or remain stationary, depending on their relative chirality, phase, and distance separating them. Multiple pairs of spiral waves, in proximity to each other, could alter the paths of the individual rotors. A spiral core will be influenced most by the rotor that is closest to it, depending on the nature of the corresponding spiral wave arm. We observed rotors lying within a limiting distance of each other attract and annihilate. Otherwise, they push each other away until they reach a critical distance, beyond which all interactions seem to cease. We have established a relationship of this critical distance to the properties of the spiral wave. We also observed spontaneous symmetry-breaking instability for a system of up to eight rotors. Our experiments with the Belousov-Zhabotinsky reaction have successfully demonstrated the validity of the numerical results. A thorough understanding of the dynamics of several spiral rotors within a small area could help us perceive the nature of such excitation waves in cardiac tissue and cell membranes.

Dynamical robustness of complex networks subject to long-range connectivity

In spite of a few attempts in understanding the dynamical robustness of complex networks, this extremely important subject of research is still in its dawn as compared to the other dynamical processes on networks. We hereby consider the concept of long-range interactions among the dynamical units of complex networks and demonstrate for the first time that such a characteristic can have noteworthy impacts on the dynamical robustness of networked systems, regardless of the underlying network topology. We present a comprehensive analysis of this phenomenon on top of diverse network architectures. Such dynamical damages being able to substantially affect the network performance, determining mechanisms that boost the robustness of networks becomes a fundamental question. In this work, we put forward a prescription based upon self-feedback that can efficiently resurrect global rhythmicity of complex networks composed of active and inactive dynamical units, and thus can enhance the network robustness. We have been able to delineate the whole proposition analytically while dealing with all d -path adjacency matrices, having an excellent agreement with the numerical results. For the numerical computations, we examine scale-free networks, Watts–Strogatz small-world model and also Erdös–Rényi random network, along with Landau–Stuart oscillators for casting the local dynamics.

Oscillation suppression and chimera states in time-varying networks

Complex network theory has offered a powerful platform for the study of several natural dynamic scenarios, based on the synergy between the interaction topology and the dynamics of its constituents. With research in network theory being developed so fast, it has become extremely necessary to move from simple network topologies to more sophisticated and realistic descriptions of the connectivity patterns. In this context, there is a significant amount of recent works that have emerged with enormous evidence establishing the time-varying nature of the connections among the constituents in a large number of physical, biological, and social systems. The recent review article by Ghosh et al. [Phys. Rep. 949, 1-63 (2022)] demonstrates the significance of the analysis of collective dynamics arising in temporal networks. Specifically, the authors put forward a detailed excerpt of results on the origin and stability of synchronization in time-varying networked systems. However, among the complex collective dynamical behaviors, the study of the phenomenon of oscillation suppression and that of other diverse aspects of synchronization are also considered to be central to our perception of the dynamical processes over networks. Through this review, we discuss the principal findings from the research studies dedicated to the exploration of the two collective states, namely, oscillation suppression and chimera on top of time-varying networks of both static and mobile nodes. We delineate how temporality in interactions can suppress oscillation and induce chimeric patterns in networked dynamical systems, from effective analytical approaches to computational aspects, which is described while addressing these two phenomena. We further sketch promising directions for future research on these emerging collective behaviors in time-varying networks.

Effects of propagation delay in coupled oscillators under direct-indirect coupling: Theory and experiment

Propagation delay arises in a coupling channel due to the finite propagation speed of signals and the dispersive nature of the channel. In this paper, we study the effects of propagation delay that appears in the indirect coupling path of direct (diffusive)-indirect (environmental) coupled oscillators. In sharp contrast to the direct coupled oscillators where propagation delay induces amplitude death, we show that in the case of direct-indirect coupling, even a small propagation delay is conducive to an oscillatory behavior. It is well known that simultaneous application of direct and indirect coupling is the general mechanism for amplitude death. However, here we show that the presence of propagation delay hinders the death state and helps the revival of oscillation. We demonstrate our results by considering chaotic time-delayed oscillators and FitzHugh-Nagumo oscillators. We use linear stability analysis to derive the explicit conditions for the onset of oscillation from the death state. We also verify the robustness of our results in an electronic hardware level experiment. Our study reveals that the effect of time delay on the dynamics of coupled oscillators is coupling function dependent and, therefore, highly non-trivial.

Oscillation behavior driven by processing delay in diffusively coupled inactive systems: Cluster synchronization and multistability

Couplings involving time delay play a relevant role in the dynamical behavior of complex systems. In this work, we address the effect of processing delay, which is a specific kind of coupling delay, on the steady state of general nonlinear systems and prove that it may drive the system to Hopf bifurcation and, in turn, to a rich oscillatory behavior. Additionally, one may observe multistable states and size-dependent cluster synchronization. We derive the analytic conditions to obtain an oscillatory regime and confirm the result by numerically simulated experiments on different oscillator networks. Our results demonstrate the importance of processing delay for complex systems and pave the way for a better understanding of dynamical control and synchronization in oscillatory networks.

Personalized Low-Energy Defibrillation Through Feedback Based Resynchronization Therapy

AIMS

Defibrillation shocks may cause AV node burnout, scar formation, and pain. In this study, we present a real-time feedback-based control of ventricular fibrillation (VF) with a series of low-energy shocks using ventricular electrical activity as the feedback input.

METHODS

Isolated rabbit hearts were Langendorff perfused and stained with a fluorescent Vm dye. The ventricular activity was measured with a pair of photodiodes, and processed with a feedback controller to calculate defibrillation shock parameters in real-time. Shock timing was based on desynchronized activation of the left and right ventricles during VF, and the strength was proportional to the amplitude difference of the photodiode signals. Shocks were delivered with a custom-developed arbitrary waveform trans-conductance amplifier.

RESULTS

Feedback based resynchronization therapy converts VT to MT before sinus rhythm is restored with a reduction of defibrillation energy, compared to a single biphasic shock.

CONCLUSIONS

Feedback based resynchronization therapy is based on real-time sensing of ventricular activity, while a series of low-energy shocks are delivered, reducing the risk of associated side effects.

Follow the Light - From Low-Energy Defibrillation to Multi-Site Photostimulation

One major cause of death in the industrialized world is sudden cardiac death, which so far can be reliably treated only by applying strong electrical shocks. Developing improved methods, aiming at lowering shock intensity and associated side effects potentially has significant clinical implications. Thus, optogenetic stimulation using structured illumination has been introduced as a promising experimental tool to investigate mechanisms underlying multi-site pacing and to optimize potential low-energy approaches. Furthermore, an objective of this work is to strengthen the application of optogenetic tools for cardiac arrhythmia research, which in turn is expected to improve applicable technologies towards tissue-protective defibrillation.

Low pass filtering mechanism enhancing dynamical robustness in coupled oscillatory networks

A network that consists of a set of active and inactive nodes is called a damaged network and this type of network shows an aging effect (degradation of dynamical activity). This dynamical deterioration affects the normal functioning of the network and also its performance. Therefore, it is necessary to design a proper mechanism to avoid undesired dynamical activity like degradation. In this work, an efficient mechanism, called the low pass filtering technique, is proposed to enhance the dynamical activity of damaged networks of coupled oscillators. Using this mechanism, the dynamic behavior of the damaged network of coupled active and inactive dynamical units is improved and the network survivability is ensured. Because a minor deviation of the controlling parameter is sufficient to restore the oscillatory behavior when the entire network undergoes an aging transition. Even when the whole network degrades due to the deterioration of each node, the larger values of the interaction strength and the controlling parameter play a key role in favor of the revival of dynamic activity in the entire network. Our proposed mechanism is very simple and effective to recover the dynamic features of a damaged network. The effectiveness of this technique has been testified in globally coupled and Erdős Rényi random networks of Stuart-Landau oscillators.

Energy-Reduced Arrhythmia Termination Using Global Photostimulation in Optogenetic Murine Hearts

Complex spatiotemporal non-linearity as observed during cardiac arrhythmia strongly correlates with vortex-like excitation wavelengths and tissue characteristics. Therefore, the control of arrhythmic patterns requires fundamental understanding of dependencies between onset and perpetuation of arrhythmia and substrate instabilities. Available treatments, such as drug application or high-energy electrical shocks, are discussed for potential side effects resulting in prognosis worsening due to the lack of specificity and spatiotemporal precision. In contrast, cardiac optogenetics relies on light sensitive ion channels stimulated to trigger excitation of cardiomyocytes solely making use of the inner cell mechanisms. This enables low-energy, non-damaging optical control of cardiac excitation with high resolution. Recently, the capability of optogenetic cardioversion was shown in Channelrhodopsin-2 (ChR2) transgenic mice. But these studies used mainly structured and local illumination for cardiac stimulation. In addition, since optogenetic and electrical stimulus work on different principles to control the electrical activity of cardiac tissue, a better understanding of the phenomena behind optogenetic cardioversion is still needed. The present study aims to investigate global illumination with regard to parameter characterization and its potential for cardioversion. Our results show that by tuning the light intensity without exceeding 1.10 mW mm-2, a single pulse in the range of 10–1,000 ms is sufficient to reliably reset the heart into sinus rhythm. The combination of our panoramic low-intensity photostimulation with optical mapping techniques visualized wave collision resulting in annihilation as well as propagation perturbations as mechanisms leading to optogenetic cardioversion, which seem to base on other processes than electrical defibrillation. This study contributes to the understanding of the roles played by epicardial illumination, pulse duration and light intensity in optogenetic cardioversion, which are the main variables influencing cardiac optogenetic control, highlighting the advantages and insights of global stimulation. Therefore, the presented results can be modules in the design of novel illumination technologies with specific energy requirements on the way toward tissue-protective defibrillation techniques.

Resumption of dynamism in damaged networks of coupled oscillators

Deterioration in dynamical activities may come up naturally or due to environmental influences in a massive portion of biological and physical systems. Such dynamical degradation may have outright effect on the substantive network performance. This requires us to provide some proper prescriptions to overcome undesired circumstances. In this paper, we present a scheme based on external feedback that can efficiently revive dynamism in damaged networks of active and inactive oscillators and thus enhance the network survivability. Both numerical and analytical investigations are performed in order to verify our claim. We also provide a comparative study on the effectiveness of this mechanism for feedbacks to the inactive group or to the active group only. Most importantly, resurrection of dynamical activity is realized even in time-delayed damaged networks, which are considered to be less persistent against deterioration in the form of inactivity in the oscillators. Furthermore, prominence in our approach is substantiated by providing evidence of enhanced network persistence in complex network topologies taking small-world and scale-free architectures, which makes the proposed remedy quite general. Besides the study in the network of Stuart-Landau oscillators, affirmative influence of external feedback has been justified in the network of chaotic Rössler systems as well.

Spirals in a reaction-diffusion system: Dependence of wave dynamics on excitability

A detailed study of the effects of excitability of the Belousov-Zhabotinsky (BZ) reaction on spiral wave properties has been carried out. Using the Oregonator model, we explore the various regimes of wave activity, from sustained oscillations to wave damping, as the system undergoes a Hopf bifurcation, that is achieved by varying the excitability parameter, ε. We also discover a short range of parameter values where random oscillations are observed. With an increase in the value of ε, the frequency of the wave decreases exponentially, as the dimension of the spiral core expands. These numerical results are confirmed by carrying out experiments in thin layers of the BZ system, where the excitability is changed by varying the concentrations of the reactant species. Effect of reactant concentrations on wave properties like time period and wavelength are also explored in detail. Drifting and meandering spirals are found in the parameter space under investigation, with the excitability affecting the tip trajectory in a way predicted by the numerical studies. This study acts as a quantitative evidence of the relationship between the excitability parameter, ε, and the substrate concentrations.

Survivability of a metapopulation under local extinctions

A metapopulation structure in landscape ecology comprises a group of interacting spatially separated subpopulations or patches of the same species that may experience several local extinctions. This makes the investigation of survivability (in the form of global oscillation) of a metapopulation on top of diverse dispersal topologies extremely crucial. However, among various dispersal topologies in ecological networks, which one can provide higher metapopulation survivability under local extinction is still not well explored. In this article, we scrutinize the robustness of an ecological network consisting of prey-predator patches having Holling type I functional response, against progressively extinct population patches. We present a comprehensive study on this while considering global, small-world, and scale-free dispersal of the subpopulations. Furthermore, we extend our work in enhancing survivability in the form of sustained global oscillation by introducing asymmetries in the dispersal rates of the considered species. Our findings affirm that the asynchrony among the patches plays an important role in the survivability of a metapopulation. In order to demonstrate the model independence of the observed phenomenon, we perform a similar analysis for patches exhibiting Holling type II functional response. On the grounds of the obtained results, our work is expected to provide a better perception of the influence of dispersal arrangements on the global survivability of ecological networks.

The impact of propagation and processing delays on amplitude and oscillation deaths in the presence of symmetry-breaking coupling

We numerically investigate the impacts of both propagation and processing delays on the emergences of amplitude death (AD) and oscillation death (OD) in one system of two Stuart-Landau oscillators with symmetry-breaking coupling. In either the absence of or the presence of propagation delay, the processing delay destabilizes both AD and OD by revoking the stability of the stable homogenous and inhomogenous steady states. In the AD to OD transition, the processing delay destabilizes first OD from large values of coupling strength until its stable regime completely disappears and then AD from both the upper and lower bounds of the stable coupling interval. Our numerical study sheds new insight lights on the understanding of nontrivial effects of time delays on dynamic activity of coupled nonlinear systems.

Spontaneous symmetry breaking due to the trade-off between attractive and repulsive couplings

Spontaneous symmetry breaking is an important phenomenon observed in various fields including physics and biology. In this connection, we here show that the trade-off between attractive and repulsive couplings can induce spontaneous symmetry breaking in a homogeneous system of coupled oscillators. With a simple model of a system of two coupled Stuart-Landau oscillators, we demonstrate how the tendency of attractive coupling in inducing in-phase synchronized (IPS) oscillations and the tendency of repulsive coupling in inducing out-of-phase synchronized oscillations compete with each other and give rise to symmetry breaking oscillatory states and interesting multistabilities. Further, we provide explicit expressions for synchronized and antisynchronized oscillatory states as well as the so called oscillation death (OD) state and study their stability. If the Hopf bifurcation parameter (λ) is greater than the natural frequency (ω) of the system, the attractive coupling favors the emergence of an antisymmetric OD state via a Hopf bifurcation whereas the repulsive coupling favors the emergence of a similar state through a saddle-node bifurcation. We show that an increase in the repulsive coupling not only destabilizes the IPS state but also facilitates the reentrance of the IPS state.

Spiral-wave dynamics in a mathematical model of human ventricular tissue with myocytes and Purkinje fibers

We present systematic numerical studies of the possible effects of the coupling of human endocardial and Purkinje cells at cellular and two-dimensional tissue levels. We find that the autorhythmic-activity frequency of the Purkinje cell in a composite decreases with an increase in the coupling strength; this can even eliminate the autorhythmicity. We observe a delay between the beginning of the action potentials of endocardial and Purkinje cells in a composite; such a delay increases as we decrease the diffusive coupling, and eventually a failure of transmission occurs. An increase in the diffusive coupling decreases the slope of the action-potential-duration-restitution curve of an endocardial cell in a composite. By using a minimal model for the Purkinje network, in which we have a two-dimensional, bilayer tissue, with a layer of Purkinje cells on top of a layer of endocardial cells, we can stabilize spiral-wave turbulence; however, for a sparse distribution of Purkinje-ventricular junctions, at which these two layers are coupled, we can also obtain additional focal activity and many complex transient regimes. We also present additional effects resulting from the coupling of Purkinje and endocardial layers and discuss the relation of our results to the studies performed in anatomically accurate models of the Purkinje network.

Optogenetic Light Crafting Tools for the Control of Cardiac Arrhythmias

The control of spatiotemporal dynamics in biological systems is a fundamental problem in nonlinear sciences and has important applications in engineering and medicine. Optogenetic tools combined with advanced optical technologies provide unique opportunities to develop and validate novel approaches to control spatiotemporal complexity in neuronal and cardiac systems. Understanding of the mechanisms and instabilities underlying the onset, perpetuation, and control of cardiac arrhythmias will enable the development and translation of novel therapeutic approaches. Here we describe in detail the preparation and optical mapping of transgenic channelrhodopsin-2 (ChR2) mouse hearts, cardiac cell cultures, and the optical setup for photostimulation using digital light processing.

Dynamics and Molecular Mechanisms of Ventricular Fibrillation in Structurally Normal Hearts

Ventricular fibrillation (VF) is the most severe cardiac rhythm disturbance and one of the most important immediate causes of sudden cardiac death. In the structurally normal heart, a small number of stable reentrant sources, perhaps 1 or 2, underlie the mechanism of VF, and the stabilization of the sources, their frequency, and the complexity of the turbulent waves they generate depend on the expression, spatial distribution, and intermolecular interactions of the 2 most important ion channels that control cardiac excitability: the inward rectifier potassium channel, Kir2.1, and the alpha subunit of the main cardiac sodium channel, NaV1.5.

Reviving oscillation with optimal spatial period of frequency distribution in coupled oscillators

The spatial distributions of system's frequencies have significant influences on the critical coupling strengths for amplitude death (AD) in coupled oscillators. We find that the left and right critical coupling strengths for AD have quite different relations to the increasing spatial period m of the frequency distribution in coupled oscillators. The left one has a negative linear relationship with m in log-log axis for small initial frequency mismatches while remains constant for large initial frequency mismatches. The right one is in quadratic function relation with spatial period m of the frequency distribution in log-log axis. There is an optimal spatial period m₀ of frequency distribution with which the coupled system has a minimal critical strength to transit from an AD regime to reviving oscillation. Moreover, the optimal spatial period m₀ of the frequency distribution is found to be related to the system size N. Numerical examples are explored to reveal the inner regimes of effects of the spatial frequency distribution on AD.

Revival of oscillation from mean-field-induced death: Theory and experiment

The revival of oscillation and maintaining rhythmicity in a network of coupled oscillators offer an open challenge to researchers as the cessation of oscillation often leads to a fatal system degradation and an irrecoverable malfunctioning in many physical, biological, and physiological systems. Recently a general technique of restoration of rhythmicity in diffusively coupled networks of nonlinear oscillators has been proposed in Zou et al. [Nat. Commun. 6, 7709 (2015)], where it is shown that a proper feedback parameter that controls the rate of diffusion can effectively revive oscillation from an oscillation suppressed state. In this paper we show that the mean-field diffusive coupling, which can suppress oscillation even in a network of identical oscillators, can be modified in order to revoke the cessation of oscillation induced by it. Using a rigorous bifurcation analysis we show that, unlike other diffusive coupling schemes, here one has two control parameters, namely the density of the mean-field and the feedback parameter that can be controlled to revive oscillation from a death state. We demonstrate that an appropriate choice of density of the mean field is capable of inducing rhythmicity even in the presence of complete diffusion, which is a unique feature of this mean-field coupling that is not available in other coupling schemes. Finally, we report the experimental observation of revival of oscillation from the mean-field-induced oscillation suppression state that supports our theoretical results.

Stabilization of three-dimensional scroll waves and suppression of spatiotemporal chaos by heterogeneities

Scroll waves in a three-dimensional medium with negative filament tension may break up and display spatiotemporal chaos. The presence of heterogeneities can influence the evolution of the medium, in particular scroll waves may pin to such heterogeneities. We show that as a result the medium may be stabilized by heterogeneities of a suitably chosen geometry. Thin rodlike heterogeneities suppress otherwise developing spatiotemporal chaos and additionally clear out already existing chaotic excitation patterns.

Feedback as a mechanism for the resurrection of oscillations from death states

The quenching of oscillations in interacting systems leads to several unwanted situations, which necessitate a suitable remedy to overcome the quenching. In this connection, this work addresses a mechanism that can resurrect oscillations in a typical situation. Through both numerical and analytical studies, we show that the candidate which is capable of resurrecting oscillations is nothing but the feedback, the one which is profoundly used in dynamical control and in biotherapies. Even in the case of a rather general system, we demonstrate analytically the applicability of the technique over one of the oscillation quenched states called amplitude death states. We also discuss some of the features of this mechanism such as adaptability of the technique with the feedback of only a few of the oscillators.

Optical Mapping of Ventricular Fibrillation Dynamics

There is very limited information regarding the dynamic patterns of the electrical activity during ventricular fibrillation (VF) in humans. Most of the data used to generate and test hypotheses regarding the mechanisms of VF come from animal models and computer simulations and the quantification of VF patterns is non-trivial. Many of the experimental recordings of the dynamic spatial patterns of VF have been obtained from mammals using "optical mapping" or "video imaging" technology in which "phase maps" are derived from high-resolution transmembrane recordings from the heart surface. The surface manifestation of the unstable reentrant waves sustaining VF can be identified as "phase singularities" and their number and location provide one measure of VF complexity. After providing a brief history of optical mapping of VF, we compare and contrast a quantitative analysis of VF patterns from the heart surface for four different animal models, hence providing physiological insight into the variety of VF dynamics among species. We found that in all four animal models the action potential duration restitution slope was actually negative during VF and that the spatial dispersion of electrophysiological parameters were not different during the first second of VF compared to pacing immediately before VF initiation. Surprisingly, our results suggest that APD restitution and spatial dispersion may not be essential causes of VF dynamics. Analyses of electrophysiological quantities in the four animal models are consistent with the idea that VF is essentially a two-dimensional phenomenon in small rabbit hearts whose size are near the boundary of the "critical mass" required to sustain VF, while VF in large pig hearts is three-dimensional and exhibits the maximal theoretical phase singularity density, and thus will not terminate spontaneously.

Unpinning of scroll waves under the influence of a thermal gradient

Three-dimensional scroll waves of electrical activity are among the mechanisms believed to be responsible for the rapid, unsynchronized contraction of cardiac ventricles, thereby reducing the heart's ability to pump blood. Scroll waves can attach themselves to unexcitable obstacles, and this sometimes highly elongates their life span. Hence, the unpinning and annihilation of these vortices has attracted much attention in recent decades. In this work, we study the influence of a thermal gradient on scroll waves pinned to inert obstacles, in the Belousov-Zhabotinsky reaction. Under a temperature gradient, scroll rings were seen to unpin from these obstacles, thus strikingly reducing their lifetimes. These results were also reproduced by numerical simulations using the Barkley model.

Spiral-wave dynamics in ionically realistic mathematical models for human ventricular tissue: the effects of periodic deformation

We carry out an extensive numerical study of the dynamics of spiral waves of electrical activation, in the presence of periodic deformation (PD) in two-dimensional simulation domains, in the biophysically realistic mathematical models of human ventricular tissue due to (a) ten-Tusscher and Panfilov (the TP06 model) and (b) ten-Tusscher, Noble, Noble, and Panfilov (the TNNP04 model). We first consider simulations in cable-type domains, in which we calculate the conduction velocity θ and the wavelength λ of a plane wave; we show that PD leads to a periodic, spatial modulation of θ and a temporally periodic modulation of λ; both these modulations depend on the amplitude and frequency of the PD. We then examine three types of initial conditions for both TP06 and TNNP04 models and show that the imposition of PD leads to a rich variety of spatiotemporal patterns in the transmembrane potential including states with a single rotating spiral (RS) wave, a spiral-turbulence (ST) state with a single meandering spiral, an ST state with multiple broken spirals, and a state SA in which all spirals are absorbed at the boundaries of our simulation domain. We find, for both TP06 and TNNP04 models, that spiral-wave dynamics depends sensitively on the amplitude and frequency of PD and the initial condition. We examine how these different types of spiral-wave states can be eliminated in the presence of PD by the application of low-amplitude pulses by square- and rectangular-mesh suppression techniques. We suggest specific experiments that can test the results of our simulations.

Alternans and Spiral Breakup in an Excitable Reaction-Diffusion System: A Simulation Study

The determination of the mechanisms of spiral breakup in excitable media is still an open problem for researchers. In the context of cardiac electrophysiological activities, spiral breakup exhibits complex spatiotemporal pattern known as ventricular fibrillation. The latter is the major cause of sudden cardiac deaths all over the world. In this paper, we numerically study the instability of periodic planar traveling wave solution in two dimensions. The emergence of stable spiral pattern is observed in the considered model. This pattern occurs when the heart is malfunctioning (i.e., ventricular tachycardia). We show that the spiral wave breakup is a consequence of the transverse instability of the planar traveling wave solutions. The alternans, that is, the oscillation of pulse widths, is observed in our simulation results. Moreover, we calculate the widths of spiral pulses numerically and observe that the stable spiral pattern bifurcates to an oscillatory wave pattern in a one-parameter family of solutions. The spiral breakup occurs far below the bifurcation when the maximum and the minimum excited states become more distinct, and hence the alternans becomes more pronounced.

Localized rotational activation in the left atrium during human atrial fibrillation: relationship to complex fractionated atrial electrograms and low-voltage zones

BACKGROUND

In humans, the existence of rotors or reentrant sources maintaining atrial fibrillation (AF) and the underlying electroanatomic substrate has not been well defined.

OBJECTIVE

Our aim was to determine the prevalence of localized rotational activation (RotA) in the left atrium (LA) during human AF and whether complex fractionated atrial electrograms (CFAEs) or low-voltage areas colocalize with RotA sites.

METHODS

We prospectively studied 32 patients (mean age 57 ± 8 years; 88% with persistent AF) undergoing AF catheter ablation. Bipolar electrograms were recorded for 2.5 seconds during AF using a roving 20-pole circular catheter in the LA. RotA was defined as sequential temporal activation of bipoles around the circular catheter. Bipolar electrogram fractionation index and bipolar voltage were used to define CFAEs and low-voltage areas, respectively.

RESULTS

In 21 (66%) patients, 47 RotA sites were identified. Few (9%) lasted 2.5 seconds (cycle length 183 ± 6 ms), while the majority (91%) were nonsustained (duration 610 ± 288 ms; cycle length 149 ± 11 ms). RotA was most common in the pulmonary vein antrum (71%) and posterior LA (25%). CFAEs were recorded from 18% ± 12% of LA area, and most (92% ± 7%) were not associated with RotA sites. However, 85% of RotA sites contained CFAEs. Very low voltage (<0.1 mV) areas comprised 12% ± 10% of LA area and were present in 23% of RotA sites.

CONCLUSIONS

In patients with predominantly persistent AF, localized RotA is commonly present but tends to be transient (<1 second). Although most CFAEs do not colocalize with RotA sites, the high prevalence of CFAEs and very low voltages within RotA sites may indicate slow conduction in diseased myocardium necessary for their maintenance.

Visual data mining with self-organising maps for ventricular fibrillation analysis

Detection of ventricular fibrillation (VF) at an early stage is being deeply studied in order to lower the risk of sudden death and allows the specialist to have greater reaction time to give the patient a good recovering therapy. Some works are focusing on detecting VF based on numerical analysis of time-frequency distributions, but in general the methods used do not provide insight into the problem. However, this study proposes a new methodology in order to obtain information about this problem. This work uses a supervised self-organising map (SOM) to obtain visually information among four important groups of patients: VF (ventricular fibrillation), VT (ventricular tachycardia), HP (healthy patients) and AHR (other anomalous heart rates and noise). A total number of 27 variables were obtained from continuous surface ECG recordings in standard databases (MIT and AHA), providing information in the time, frequency, and time-frequency domains. self-organising maps (SOMs), trained with 11 of the 27 variables, were used to extract knowledge about the variable values for each group of patients. Results show that the SOM technique allows to determine the profile of each group of patients, assisting in gaining a deeper understanding of this clinical problem. Additionally, information about the most relevant variables is given by the SOM analysis.

Reviving oscillations in coupled nonlinear oscillators

By introducing a processing delay in the coupling, we find that it can effectively annihilate the quenching of oscillation, amplitude death (AD), in a network of coupled oscillators by switching the stability of AD. It revives the oscillation in the AD regime to retain sustained rhythmic functioning of the networks, which is in sharp contrast to the propagation delay with the tendency to induce AD. This processing delay-induced phenomenon occurs both with and without the propagation delay. Further this effect is rather general from two coupled to networks of oscillators in all known scenarios that can exhibit AD, and it has a wide range of applications where sustained oscillations should be retained for proper functioning of the systems.

Scroll wave filaments self-wrap around unexcitable heterogeneities

Scroll waves are three-dimensional excitation vortices rotating around one-dimensional phase singularities called filaments. In experiments with a chemical reaction-diffusion system and in numerical simulations, we study the pinning of closed filament loops to inert cylindrical heterogeneities. We show that the filament wraps itself around the heterogeneity and thus avoids contraction and annihilation. This entwining steadily increases the total length of the pinned filament and reshapes the entire rotation backbone of the vortex. Self-pinning is fastest for thin cylinders with radii not much larger than the core of the unpinned rotor. The process ends when the filament is attached to the entire length of the cylinder. The possible importance of self-pinning in cardiac systems is discussed.

Spiral defect drift in the wave fields of multiple excitation patterns

Spiral waves in excitable systems decay to drifting defects if forced by high-frequency wave trains. Using the Barkley model we analyze the drift velocity in planar wave trains as a function of wave frequency. Within two antiparallel, planar wave trains of equal frequency a defect is pushed into the collision region where it stops. Within two circular wave fields, however, it continues its drift in a direction perpendicular to the axis connecting the pacemakers. Depending on the forcing frequency and the initial position, this motion occurs either away from or toward the pacemaker axis. Three circular wave fields can be used to position the defect at a unique point close to the center of the pacemaker triangle. The results are also observed in experiments with the Belousov-Zhabotinsky reaction.

Scroll-wave dynamics in human cardiac tissue: lessons from a mathematical model with inhomogeneities and fiber architecture

Cardiac arrhythmias, such as ventricular tachycardia (VT) and ventricular fibrillation (VF), are among the leading causes of death in the industrialized world. These are associated with the formation of spiral and scroll waves of electrical activation in cardiac tissue; single spiral and scroll waves are believed to be associated with VT whereas their turbulent analogs are associated with VF. Thus, the study of these waves is an important biophysical problem. We present a systematic study of the combined effects of muscle-fiber rotation and inhomogeneities on scroll-wave dynamics in the TNNP (ten Tusscher Noble Noble Panfilov) model for human cardiac tissue. In particular, we use the three-dimensional TNNP model with fiber rotation and consider both conduction and ionic inhomogeneities. We find that, in addition to displaying a sensitive dependence on the positions, sizes, and types of inhomogeneities, scroll-wave dynamics also depends delicately upon the degree of fiber rotation. We find that the tendency of scroll waves to anchor to cylindrical conduction inhomogeneities increases with the radius of the inhomogeneity. Furthermore, the filament of the scroll wave can exhibit drift or meandering, transmural bending, twisting, and break-up. If the scroll-wave filament exhibits weak meandering, then there is a fine balance between the anchoring of this wave at the inhomogeneity and a disruption of wave-pinning by fiber rotation. If this filament displays strong meandering, then again the anchoring is suppressed by fiber rotation; also, the scroll wave can be eliminated from most of the layers only to be regenerated by a seed wave. Ionic inhomogeneities can also lead to an anchoring of the scroll wave; scroll waves can now enter the region inside an ionic inhomogeneity and can display a coexistence of spatiotemporal chaos and quasi-periodic behavior in different parts of the simulation domain. We discuss the experimental implications of our study.

Spiral-wave turbulence and its control in the presence of inhomogeneities in four mathematical models of cardiac tissue

Regular electrical activation waves in cardiac tissue lead to the rhythmic contraction and expansion of the heart that ensures blood supply to the whole body. Irregularities in the propagation of these activation waves can result in cardiac arrhythmias, like ventricular tachycardia (VT) and ventricular fibrillation (VF), which are major causes of death in the industrialised world. Indeed there is growing consensus that spiral or scroll waves of electrical activation in cardiac tissue are associated with VT, whereas, when these waves break to yield spiral- or scroll-wave turbulence, VT develops into life-threatening VF: in the absence of medical intervention, this makes the heart incapable of pumping blood and a patient dies in roughly two-and-a-half minutes after the initiation of VF. Thus studies of spiral- and scroll-wave dynamics in cardiac tissue pose important challenges for in vivo and in vitro experimental studies and for in silico numerical studies of mathematical models for cardiac tissue. A major goal here is to develop low-amplitude defibrillation schemes for the elimination of VT and VF, especially in the presence of inhomogeneities that occur commonly in cardiac tissue. We present a detailed and systematic study of spiral- and scroll-wave turbulence and spatiotemporal chaos in four mathematical models for cardiac tissue, namely, the Panfilov, Luo-Rudy phase 1 (LRI), reduced Priebe-Beuckelmann (RPB) models, and the model of ten Tusscher, Noble, Noble, and Panfilov (TNNP). In particular, we use extensive numerical simulations to elucidate the interaction of spiral and scroll waves in these models with conduction and ionic inhomogeneities; we also examine the suppression of spiral- and scroll-wave turbulence by low-amplitude control pulses. Our central qualitative result is that, in all these models, the dynamics of such spiral waves depends very sensitively on such inhomogeneities. We also study two types of control schemes that have been suggested for the control of spiral turbulence, via low amplitude current pulses, in such mathematical models for cardiac tissue; our investigations here are designed to examine the efficacy of such control schemes in the presence of inhomogeneities. We find that a local pulsing scheme does not suppress spiral turbulence in the presence of inhomogeneities; but a scheme that uses control pulses on a spatially extended mesh is more successful in the elimination of spiral turbulence. We discuss the theoretical and experimental implications of our study that have a direct bearing on defibrillation, the control of life-threatening cardiac arrhythmias such as ventricular fibrillation.

Epicardial mapping of ventricular fibrillation over the posterior descending artery and left posterior papillary muscle of the swine heart

BACKGROUND

Recent studies suggest that during ventricular fibrillation (VF) epicardial vessels may be a site of conduction block and the posterior papillary muscle (PPM) in the left ventricle (LV) may be the location of a "mother rotor." The goal of this study was to obtain evidence to support or refute these possibilities.

METHODS

Epicardial activation over the posterior LV and right ventricle (RV) was mapped during the first 20 s of electrically induced VF in six open-chest pigs with a 504 electrode plaque covering a 20 cm(2) area centered over the posterior descending artery (PDA).

RESULTS

The locations of epicardial breakthrough as well as reentry clustered in time and space during VF. Spatially, reentry occurred significantly more frequently over the LV than the RV in all 48 episodes, and breakthrough clustered near the PPM (p < 0.001). Significant temporal clustering occurred in 79% of breakthrough episodes and 100% of reentry episodes. These temporal clusters occurred at different times so that there was significantly less breakthrough when reentry was present (p < 0.0001). Conduction block occurred significantly more frequently near the PDA than elsewhere.

CONCLUSIONS

The PDA is a site of epicardial block which may contribute to VF maintenance. Epicardial breakthrough clusters near the PPM. Reentry also clusters in space but at a separate site. The fact that breakthrough and reentry cluster at different locations and at different times supports the possibility of a drifting filament at the PPM so that at times reentry is present on the surface but at other times the reentrant wavefront breaks through to the epicardium.

Electrical remodeling contributes to complex tachyarrhythmias in connexin43-deficient mouse hearts

Loss of connexin43 (Cx43) gap junction channels in the heart results in a marked increase in the incidence of spontaneous and inducible polymorphic ventricular tachyarrhythmias (PVTs). The mechanisms resulting in this phenotype remain unclear. We hypothesized that uncoupling promotes regional ion channel remodeling, thereby increasing electrical heterogeneity and facilitating the development of PVT. In isolated-perfused control hearts, programmed electrical stimulation elicited infrequent monomorphic ventricular tachyarrhythmias (MVT), and dominant frequencies (DFs) during MVT were similar in the right ventricle (RV) and left ventricle (LV). Moreover, conduction properties, action potential durations (APDs), and repolarizing current densities were similar in RV and LV myocytes. In contrast, PVT was common in Cx43 conditional knockout (OCKO) hearts, and arrhythmias were characterized by significantly higher DFs in the RV compared to the LV. APDs in OCKO myocytes were significantly shorter than those from chamber-matched controls, with RV OCKO myocytes being most affected. APD shortening was associated with higher levels of sustained current in myocytes from both chambers as well as higher levels of the inward rectifier current only in RV myocytes. Thus, alterations in cell-cell coupling lead to regional changes in potassium current expression, which in this case facilitates the development of reentrant arrhythmias. We propose a new mechanistic link between electrical uncoupling and ion channel remodeling. These findings may be relevant not only in cardiac tissue but also to other organ systems where gap junction remodeling is known to occur.

The role of photon scattering in optical signal distortion during arrhythmia and defibrillation

Optical mapping of arrhythmias and defibrillation provides important insights; however, a limitation of the technique is signal distortion due to photon scattering. The goal of this experimental/simulation study is to investigate the role of three-dimensional photon scattering in optical signal distortion during ventricular tachycardia (VT) and defibrillation. A three-dimensional realistic bidomain rabbit ventricular model was combined with a model of photon transport. Shocks were applied via external electrodes to induce sustained VT, and transmembrane potentials (V(m)) were compared with synthesized optical signals (V(opt)). Fluorescent recordings were conducted in isolated rabbit hearts to validate simulation results. Results demonstrate that shock-induced membrane polarization magnitude is smaller in V(opt) and in experimental signals as compared to V(m). This is due to transduction of potentials from weakly polarized midmyocardium to the epicardium. During shock-induced reentry and in sustained VT, photon scattering, combined with complex wavefront dynamics, results in optical action potentials near a filament exhibiting i), elevated resting potential, ii), reduced amplitude relative to pacing, and iii), dual-humped morphologies. A shift of up to 4 mm in the phase singularity location was observed in V(opt) maps when compared to V(m). This combined experimental/simulation study provides an interpretation of optical recordings during VT and defibrillation.

Universal scaling law of electrical turbulence in the mammalian heart

Many biological processes, such as metabolic rate and life span, scale with body mass (BM) according to the universal law of allometric scaling: Y = aBM(b) (Y, biological process; b, scaling exponent). We investigated whether the temporal properties of ventricular fibrillation (VF), the major cause of sudden and unexpected cardiac death, scale with BM. By using high-resolution optical mapping, numerical simulations and metaanalysis of VF data in 11 mammalian species, we demonstrate that the interbeat interval of VF scales as VF(cycle) (length) = 53 x BM(1/4), spanning more than four orders of magnitude in BM from mouse to horse.

Spiral-wave dynamics depend sensitively on inhomogeneities in mathematical models of ventricular tissue

Every sixth death in industrialized countries occurs because of cardiac arrhythmias such as ventricular tachycardia (VT) and ventricular fibrillation (VF). There is growing consensus that VT is associated with an unbroken spiral wave of electrical activation on cardiac tissue but VF with broken waves, spiral turbulence, spatiotemporal chaos and rapid, irregular activation. Thus spiral-wave activity in cardiac tissue has been studied extensively. Nevertheless, many aspects of such spiral dynamics remain elusive because of the intrinsically high-dimensional nature of the cardiac-dynamical system. In particular, the role of tissue heterogeneities in the stability of cardiac spiral waves is still being investigated. Experiments with conduction inhomogeneities in cardiac tissue yield a variety of results: some suggest that conduction inhomogeneities can eliminate VF partially or completely, leading to VT or quiescence, but others show that VF is unaffected by obstacles. We propose theoretically that this variety of results is a natural manifestation of a complex, fractal-like boundary that must separate the basins of the attractors associated, respectively, with spiral breakup and single spiral wave. We substantiate this with extensive numerical studies of Panfilov and Luo-Rudy I models, where we show that the suppression of spiral breakup depends sensitively on the position, size, and nature of the inhomogeneity.

Calcium instabilities in mammalian cardiomyocyte networks

The degeneration of a regular heart rhythm into fibrillation (a chaotic or chaos-like sequence) can proceed via several classical routes described by nonlinear dynamics: period-doubling, quasiperiodicity, or intermittency. In this study, we experimentally examine one aspect of cardiac excitation dynamics, the long-term evolution of intracellular calcium signals in cultured cardiomyocyte networks subjected to increasingly faster pacing rates via field stimulation. In this spatially extended system, we observed alternans and higher-order periodicities, extra beats, and skipped beats or blocks. Calcium instabilities evolved nonmonotonically with the prevalence of phase-locking or Wenckebach rhythm, low-frequency magnitude modulations (signature of quasiperiodicity), and switches between patterns with occasional bursts (signature of intermittency), but period-doubling bifurcations were rare. Six ventricular-fibrillation-resembling episodes were pace-induced, for which significantly higher complexity was confirmed by approximate entropy calculations. The progressive destabilization of the heart rhythm by coexistent frequencies, seen in this study, can be related to theoretically predicted competition of control variables (voltage and calcium) at the single-cell level, or to competition of excitation and recovery at the cell network level. Optical maps of the response revealed multiple local spatiotemporal patterns, and the emergence of longer-period global rhythms as a result of wavebreak-induced reentries.

The short QT syndrome as a paradigm to understand the role of potassium channels in ventricular fibrillation

The recently discovered hereditary channelopathy, the Short QT Syndrome (SQTS), is an important advance in clinical and molecular cardiology that has opened new doors for investigating the manner in which alterations in excitability and action potential morphology may facilitate the occurrence of ventricular fibrillation. In this brief review we address the molecular and genetic features of SQTS in which specific mutations in one of three different potassium channels involved in cardiac repolarization substantially increase the risk of life-threatening tachyarrhythmias. We then summarize new knowledge on the mechanism of wavebreak, which is the hallmark of reentry initiation, and on the role of potassium channels in the ionic mechanisms underlying cardiac excitation and its frequency dependence. The article argues for a detailed understanding of the ionic mechanisms that promote wavebreaks and stable rotors as an essential tool for successful anti-arrhythmic therapy in SQTS and other diseases leading to sudden cardiac death.

Mechanisms of ventricular fibrillation in canine models of congestive heart failure and ischemia assessed by in vivo noncontact mapping

BACKGROUND

Much of the research performed studying the mechanism of ventricular fibrillation (VF) has been in normal ventricles rather than under a pathological condition predisposing to VF. We hypothesized that different ventricular substrates would alter the mechanism and characteristics of VF.

METHODS AND RESULTS

Three groups of dogs were studied: (1) control (n=8), (2) pacing-induced congestive heart failure (n=7), and (3) acute ischemia produced by 30 minutes of mid left anterior descending artery ligation (n=5). A noncontact mapping catheter (Ensite 3000, ESI) was placed via transseptal into the left ventricle (LV), along with an electrophysiology catheter. A multielectrode basket catheter (EP Technologies) was placed in the right ventricle, along with an electrophysiology catheter. Several episodes of VF were recorded in each animal. In addition to constructing isopotential and isochronal maps of the VF episodes, signals underwent frequency domain analysis as a fast Fourier transform was performed over a 2-second window every 1 second. From the fast Fourier transform, the dominant frequency was determined, and the organization was calculated. In control dogs, meandering, reentrant spiral wave activity was the main feature of the VF. The congestive heart failure group showed evidence of a stable rotor (n=3), evidence of a focal source (n=3), or no evidence of a driver in the LV (n=1). The ischemic group showed evidence of an initial focal mechanism that transitioned into reentry. In the control and ischemic groups, the LV always had higher dominant frequencies than the right ventricle.

CONCLUSIONS

Different ventricular substrates produced by the different animal models altered the characteristics of VF. Thus, different mechanisms of VF may be present in the LV, depending on the animal model.

Molecular mechanisms and global dynamics of fibrillation: an integrative approach to the underlying basis of vortex-like reentry

Art Winfree's scientific legacy has been particularly important to our laboratory whose major goal is to understand the mechanisms of ventricular fibrillation (VF). Here, we take an integrative approach to review recent studies on the manner in which nonlinear electrical waves organize to result in VF. We describe the contribution of specific potassium channel proteins and of the myocardial fiber structure to such organization. The discussion centers on data derived from a model of stable VF in the Langendorff-perfused guinea pig heart that demonstrates distinct patterns of organization in the left (LV) and right (RV) ventricles. Analysis of optical mapping data reveals that VF excitation frequencies are distributed throughout the ventricles in clearly demarcated domains. The highest frequency domains are found on the anterior wall of the LV at a location where sustained reentrant activity is present. The optical data suggest that a high frequency rotor that remains stationary in the LV is the mechanism that sustains VF in this model. Computer simulations predict that the inward rectifying potassium current (IK1) is an essential determinant of rotor stability and frequency, and patch-clamp results strongly suggest that the outward component of IK1 of cells in the LV is significantly larger than in the RV. Additional computer simulations and analytical procedures predict that the filaments of the reentrant activity (scroll waves) adopt a non-random configuration depending on fiber organization within the ventricular wall. Using the minimal principle we have concluded that filaments align with the trajectory of least resistance (i.e. the geodesic) between their endpoints. Overall, the data discussed have opened new and potentially exciting avenues of research on the possible role played by inward rectifier channels in the mechanism of VF, as well as the organization of its reentrant sources in three-dimensional cardiac muscle. Such an integrative approach may lead us toward an understanding of the molecular and structural basis of VF and hopefully to new preventative approaches.

Examination of optical depth effects on fluorescence imaging of cardiac propagation

Optical mapping with voltage-sensitive dyes provides a high-resolution technique to observe cardiac electrodynamic behavior. Although most studies assume that the fluorescent signal is emitted from the surface layer of cells, the effects of signal attenuation with depth on signal interpretation are still unclear. This simulation study examines the effects of a depth-weighted signal on epicardial activation patterns and filament localization. We simulated filament behavior using a detailed cardiac model, and compared the signal obtained from the top (epicardial) layer of the spatial domain with the calculated weighted signal. General observations included a prolongation of the action upstroke duration, early upstroke initiation, and reduction in signal amplitude in the weighted signal. A shallow filament was found to produce a dual-humped action potential morphology consistent with previously reported observations. Simulated scroll wave breakup exhibited effects such as the false appearance of graded potentials, apparent supramaximal conduction velocities, and a spatially blurred signal with the local amplitude dependent upon the immediate subepicardial activity; the combination of these effects produced a corresponding change in the accuracy of filament localization. Our results indicate that the depth-dependent optical signal has significant consequences on the interpretation of epicardial activation dynamics.

Toward an understanding of the molecular mechanisms of ventricular fibrillation

A major goal of basic research in cardiac electrophysiology is to understand the mechanisms responsible for ventricular fibrillation (VF). Here we review recent experimental and numerical results, from the ion channel to the organ level, which might lead to a better understanding of the cellular and molecular mechanisms of VF. The discussion centers on data derived from a model of stable VF in the Langendorff-perfused guinea pig heart that demonstrate distinct patterns of organization in the left (LV) and right (RV) ventricles. Analysis of optical mapping data reveals that VF excitation frequencies are distributed throughout the ventricles in clearly demarcated domains. The highest frequency domains are usually found on the anterior wall of the LV, demonstrating that a high frequency reentrant source (a rotor) that remains stationary in the LV is the mechanism that sustains VF in this model. Computer simulations predict that the inward rectifying potassium current (IK1) is an essential determinant of rotor stability and rotation frequency, and patch-clamp results strongly suggest that the outward component of the background current (presumably IK1) of cells in the LV is significantly larger in the LV than in the RV. These data have opened a new and potentially exciting avenue of research on the possible role played by inward rectifier channels in the mechanism of VF and may lead us toward an understanding of its molecular basis and hopefully lead to new preventative approaches.