Key result
Thermal gradients and nonlinear diffusion alter repolarization and promote arrhythmogenesis in simulated fibrillation models.
Theoretical modeling demonstrates that thermo-electric coupling and nonlinear diffusion significantly alter cardiac action potential repolarization and increase the likelihood of arrhythmogenesis.
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Should not yet change arrhythmia management; hypothesis-generating for thermo-electric effects in cardiac models.
This work reports the results of the theoretical investigation of nonlinear dynamics and spiral wave breakup in a generalized two-variable model of cardiac action potential accounting for thermo-electric coupling and diffusion nonlinearities. As customary in excitable media, the common Q10 and Moore factors are used to describe thermo-electric feedback in a 10° range. Motivated by the porous nature of the cardiac tissue, in this study we also propose a nonlinear Fickian flux formulated by Taylor expanding the voltage dependent diffusion coefficient up to quadratic terms. A fine tuning of the diffusive parameters is performed a priori to match the conduction velocity of the equivalent cable model. The resulting combined effects are then studied by numerically simulating different stimulation protocols on a one-dimensional cable. Model features are compared in terms of action potential morphology, restitution curves, frequency spectra, and spatio-temporal phase differences. Two-dimensional long-run simulations are finally performed to characterize spiral breakup during sustained fibrillation at different thermal states. Temperature and nonlinear diffusion effects are found to impact the repolarization phase of the action potential wave with non-monotone patterns and to increase the propensity of arrhythmogenesis.
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Gizzi et al. (2017) studied Cardiac arrhythmias and fibrillation (Theoretical modeling). Thermo-electric coupling and nonlinear diffusion vs. Linear diffusion model (standard cable equation) was evaluated on Spatio-temporal behavior and spiral breakup during simulated fibrillation. Temperature and nonlinear diffusion effects impact the repolarization phase of the action potential wave with non-monotone patterns and increase the propensity of arrhythmogenesis.
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