Key result
Modeled apicobasal heterogeneity drives LV scroll wave rotation apically while transmural heterogeneity shortens wave lifetime.
Why the study?
Rotating spiral waves underlie dangerous cardiac arrhythmias, and myocardial heterogeneity is a factor affecting their dynamics.
Apicobasal heterogeneity in a mathematical model of the human left ventricle causes scroll waves to drift toward and rotate around the apex, suggesting the apex may be a preferable location for scroll waves, which could inform clinical interventions for arrhythmias.
May suggest apical sites for arrhythmia ablation; hypothesis-generating in models and should not yet change practice.
Rotating spiral waves of electrical excitation underlie many dangerous cardiac arrhythmias. The heterogeneity of myocardium is one of the factors that affects the dynamics of such waves. In this paper, we present results of our simulations for scroll wave dynamics in a heterogeneous model of the human left ventricle with analytical anatomically based representation of the geometry and anisotropy. We used a set of 18 coupled differential equations developed by ten Tusscher and Panfilov (TP06 model) which describes human ventricular cells based on their measured biophysical properties. We found that apicobasal heterogeneity dramatically changes the scroll wave dynamics. In the homogeneous model, the scroll wave annihilates at the base, but the moderate heterogeneity causes the wave to move to the apex and then continuously rotates around it. The rotation speed increased with the degree of the heterogeneity. However, for large heterogeneity, we observed formation of additional wavebreaks and the onset of complex spatio-temporal patterns. Transmural heterogeneity did not change the dynamics and decreased the lifetime of the scroll wave with an increase in heterogeneity. Results of our numerical experiments show that the apex may be a preferable location of the scroll wave, which may be important for development of clinical interventions.
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Pravdin et al. (2020) studied Cardiac arrhythmias. Apicobasal and transmural heterogeneity vs. Homogeneous model was evaluated on Scroll wave dynamics. Apicobasal heterogeneity in a mathematical model of the human left ventricle caused scroll waves to move to and continuously rotate around the apex, whereas transmural heterogeneity decreased lifetime.
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