February 4, 2010Circulation Arrhythmia and ElectrophysiologyOpen Access

Structural Heterogeneity Alone Is a Sufficient Substrate for Dynamic Instability and Altered Restitution

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Population

Simulated 14x14 mm domain using a modified LR1 cardiac activation model in a bidomain formulation with…

Comparison

Central region containing nonuniform… vs Absence of structural discontinuities (control)

Design

Preclinical

Authors

ZEZoar J. EngelmanDuke University MTMark L. TrewUniversity of Auckland BSBruce H. SmaillUniversity of Auckland

Discussion

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Implication

May promote reentry via amplified alternans in fibrotic animal hearts; leaves open relevance to human arrhythmia substrates.

Structured PICO

Population

Simulated 14x14 mm(2) domain using a modified LR1 cardiac activation model in a bidomain formulation with isotropic conductivities

Intervention

Central region containing nonuniform discontinuities resembling patchy fibrosis with bipolar stimulation at decreasing coupling intervals

Comparator

Absence of structural discontinuities (control)

Outcome

Electric activation, APD distributions, discordant APD alternans, conduction block, and reentrysurrogate

Computational modeling demonstrates that structural discontinuities resembling patchy fibrosis are sufficient to amplify discordant alternans and create a substrate for reentry.

Cite This Study

Engelman et al. (2010) studied this question.

synapsesocial.com/papers/6a7564d84b0395c886dbeff4 https://doi.org/10.1161/circep.109.890459

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Structural Heterogeneity Alone Is a Sufficient Substrate for Dynamic Instability and Altered Restitution

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Structural Heterogeneity Alone Is a Sufficient Substrate for Dynamic Instability and Altered Restitution

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Also Consider