Key result
Mathematical simulations of the ischaemic border zone demonstrated that newly generated scroll waves can experience negative filament tension, leading to expansion and a fibrillation-like state.
Mathematical modeling of the ischemic border zone reveals mechanisms by which 3D scroll waves can expand and multiply, potentially explaining the genesis of ischemia-reperfusion arrhythmias.
Boundary waves may trigger reperfusion arrhythmias; leaves open experimental validation before clinical targeting.
Abnormal electrical activity from the boundaries of ischemic cardiac tissue is recognized as one of the major causes in generation of ischemia-reperfusion arrhythmias. Here we present theoretical analysis of the waves of electrical activity that can rise on the boundary of cardiac cell network upon its recovery from ischaemia-like conditions. The main factors included in our analysis are macroscopic gradients of the cell-to-cell coupling and cell excitability and microscopic heterogeneity of individual cells. The interplay between these factors allows one to explain how spirals form, drift together with the moving boundary, get transiently pinned to local inhomogeneities, and finally penetrate into the bulk of the well-coupled tissue where they reach macroscopic scale. The asymptotic theory of the drift of spiral and scroll waves based on response functions provides explanation of the drifts involved in this mechanism, with the exception of effects due to the discreteness of cardiac tissue. In particular, this asymptotic theory allows an extrapolation of 2D events into 3D, which has shown that cells within the border zone can give rise to 3D analogues of spirals, the scroll waves. When and if such scroll waves escape into a better coupled tissue, they are likely to collapse due to the positive filament tension. However, our simulations have shown that such collapse of newly generated scrolls is not inevitable and that under certain conditions filament tension becomes negative, leading to scroll filaments to expand and multiply leading to a fibrillation-like state within small areas of cardiac tissue.
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Biktashev et al. (2011) studied Ischemia-reperfusion arrhythmias. Mathematical modeling was evaluated. Mathematical simulations of the ischaemic border zone demonstrated that newly generated scroll waves can experience negative filament tension, leading to expansion and a fibrillation-like state.
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