Key result
One-dimensional modeling accounts for multifractal random electrical noise dynamics during AF.
Why the study?
To account for clinical findings of multifractal intermittent cardiac impulse energy during AF by exploring the role of gap junction channel kinetics in creating imbalance between depolarizing and repolarizing currents.
A novel 1D computational model incorporating gap junction channel kinetics successfully reproduces the multifractal intermittent dynamics of cardiac electrical activity observed during atrial fibrillation.
Hypothesis-generating for AF substrate modeling; extends experimental multifractal data but leaves open clinical translation.
In a companion paper (I. Multifractal analysis of clinical data), we used a wavelet-based multiscale analysis to reveal and quantify the multifractal intermittent nature of the cardiac impulse energy in the low frequency range ≲ 2Hz during atrial fibrillation (AF). It demarcated two distinct areas within the coronary sinus (CS) with regionally stable multifractal spectra likely corresponding to different anatomical substrates. The electrical activity also showed no sign of the kind of temporal correlations typical of cascading processes across scales, thereby indicating that the multifractal scaling is carried by variations in the large amplitude oscillations of the recorded bipolar electric potential. In the present study, to account for these observations, we explore the role of the kinetics of gap junction channels (GJCs), in dynamically creating a new kind of imbalance between depolarizing and repolarizing currents. We propose a one-dimensional (1D) spatial model of a denervated myocardium, where the coupling of cardiac cells fails to synchronize the network of cardiac cells because of abnormal transjunctional capacitive charging of GJCs. We show that this non-ohmic nonlinear conduction 1D modeling accounts quantitatively well for the "multifractal random noise" dynamics of the electrical activity experimentally recorded in the left atrial posterior wall area. We further demonstrate that the multifractal properties of the numerical impulse energy are robust to changes in the model parameters.
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Attuel et al. (2019) studied Atrial fibrillation. Mathematical model of cardiac cell excitability was evaluated on Multifractal random noise dynamics of electrical activity. The one-dimensional model accounts for the multifractal random noise dynamics of electrical activity during atrial fibrillation as recorded in experimental data.
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