Key result
Myocyte-fibroblast coupling consistently promotes the occurrence of pathological dynamics such as spiral wave fibrillation, while its effect on early afterdepolarizations depends on the fibroblast resting potential.
In-silico modeling demonstrates that myocyte-fibroblast coupling in fibrotic cardiac tissue can promote the emergence of tissue-level arrhythmias from early afterdepolarizations.
Managing lethal cardiac arrhythmias is one of the biggest challenges in modern cardiology, and hence it is very important to understand the factors underlying such arrhythmias. While early afterdepolarizations (EAD) of cardiac cells is known to be one such arrhythmogenic factor, the mechanisms underlying the emergence of tissue level arrhythmias from cellular level EADs is not fully understood. Another known arrhythmogenic condition is fibrosis of cardiac tissue that occurs both due to aging and in many types of heart diseases. In this paper we describe the results of a systematic in-silico study, using the TNNP model of human cardiac cells and MacCannell model for (myo)fibroblasts, on the possible effects of diffuse fibrosis on arrhythmias occurring via EADs. We find that depending on the resting potential of fibroblasts ( V FR ), M-F coupling can either increase or decrease the region of parameters showing EADs. Fibrosis increases the probability of occurrence of arrhythmias after a single focal stimulation and this effect increases with the strength of the M-F coupling. While in our simulations, arrhythmias occur due to fibrosis induced ectopic activity, we do not observe any specific fibrotic pattern that promotes the occurrence of these ectopic sources.
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Sridhar et al. (2017) studied Cardiac arrhythmias. Myocyte-fibroblast coupling vs. Absence of myocyte-fibroblast coupling was evaluated on Onset of early afterdepolarizations and spiral wave fibrillation. Myocyte-fibroblast coupling consistently promotes the occurrence of pathological dynamics such as spiral wave fibrillation, while its effect on early afterdepolarizations depends on the fibroblast resting potential.
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