Key result
Cardiac alternans, a precursor to reentrant arrhythmias and sudden cardiac death, arises from complex non-linear dynamics involving the interplay of membrane voltage restitution and subcellular calcium cycling instability.
This review summarizes the subcellular and tissue-level mechanisms of cardiac alternans, highlighting the complex interplay between membrane voltage restitution and intracellular calcium cycling in arrhythmogenesis.
Informs arrhythmia risk assessment via alternans dynamics; leaves open whether modulating restitution or calcium cycling prevents clinical events.
Cardiac repolarization alternans is a rhythm disturbance of the heart in which rapid stimulation elicits a beat-to-beat alternation in the duration of action potentials and magnitude of intracellular calcium transients in individual cardiac myocytes. Although this phenomenon has been identified as a potential precursor to dangerous reentrant arrhythmias and sudden cardiac death, significant uncertainty remains regarding its mechanism and no clinically practical means of halting its occurrence or progression currently exists. Cardiac alternans has well-characterized tissue, cellular, and subcellular manifestations, the mechanisms and interplay of which are an active area of research.
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Gaeta et al. (2012) conducted a review in Cardiac alternans and arrhythmia. Cardiac alternans mechanisms was evaluated. Cardiac alternans, a precursor to reentrant arrhythmias and sudden cardiac death, arises from complex non-linear dynamics involving the interplay of membrane voltage restitution and subcellular calcium cycling instability.
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