Circus movement in rabbit atrial muscle as a mechanism of tachycardia. III. The "leading circle" concept: a new model of circus movement in cardiac tissue without the involvement of an anatomical obstacle.

SUMMARY In small pieces of rabbit atrial myocardium, sustained periods of circus movement tachycardia were produced by the induction of a single properly timed premature impulse. By use of multiple intracellular and extracellular electrodes the spread of activation during the tachycardia could be analyzed accurately. Because in the present experiments there was no gross anatomical obstacle for the impulse to circulate around, we paid special attention to phenomena occurring in the center of the circus movement. We found that in the absence of an inexcitable central obstacle the center of a circus movement was invaded by multiple centripetal wavelets which converged in the very center of the circuit. On the basis of these observations we developed a new model of circulating excitation in cardiac tissue. The properties of this model (referred to as the leading circle concept) were compared with the behavior of circus movement around the anatomical obstacle. It turned out that both types of circus movement tachycardia responded differently to changes in basic electrophysiological properties such as conduction velocity and refractory period. For example, addition of carbamylcholine to the tissue bath caused a marked acceleration of the leading circle tachycardia, whereas circus movement in a ring of atrial tissue was hardly affected. On the other hand, depression of conduction velocity by exposure to moderate concentrations of tetrodotoxin had a more pronounced effect on circus movement in the ring preparations than on tachycardias based on a leading circle mechanism. Finally we suggest the use of the strength-interval curve —after some modification —to describe and