Key result
Recorded extrinsic variability between individual myocytes produced a greater degree of dispersion in repolarization in tissue than the intrinsic beat-to-beat variability of each myocyte.
Computational modeling demonstrates that extrinsic variability between myocytes contributes more to dispersion of repolarization in cardiac tissue than intrinsic beat-to-beat variability.
Extrinsic myocyte variability may dominate repolarization dispersion; hypothesis-generating for arrhythmia mechanisms, requires validation before clinical translation.
Variability in the action potential of isolated myocytes and tissue samples is observed in experimental studies. Variability is manifested as both differences in the action potential (AP) morphology between cells (extrinsic variability), and also 'intrinsic' or beat-to-beat variability of repolarization (BVR) in the AP duration of each cell. We studied the relative contributions of experimentally recorded intrinsic and extrinsic variability to dispersion of repolarization in tissue. We developed four cell-specific parameterizations of a phenomenological stochastic differential equation AP model exhibiting intrinsic variability using APs recorded from isolated guinea pig ventricular myocytes exhibiting BVR. We performed simulations in tissue using the four different model parameterizations in the presence and the absence of both intrinsic and extrinsic variability. We altered the coupling of the tissue to determine how inter-cellular coupling affected the dispersion of the AP duration in tissue. Both intrinsic and extrinsic variability were gradually revealed by reduction of tissue coupling. However, the recorded extrinsic variability between individual myocytes produced a greater degree of dispersion in repolarization in tissue than the intrinsic variability of each myocyte.
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Walmsley et al. (2014) studied Cardiac electrophysiological variability. Simulation of intrinsic and extrinsic variability in tissue coupling vs. Absence of intrinsic and extrinsic variability was evaluated on Dispersion of repolarization in tissue. Recorded extrinsic variability between individual myocytes produced a greater degree of dispersion in repolarization in tissue than the intrinsic beat-to-beat variability of each myocyte.
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