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The effect of vagally induced dispersion of action potential duration on atrial arrhythmogenesis.

Abstract：

OBJECTIVE:The purpose of this study is to ascertain the effects of spatially variable ACh distributions on arrhythmogenesis in a morphologically realistic computer model of canine atria. BACKGROUND:Vagal stimulation releases acetylcholine (ACh), which causes a dose-dependent reduction in action potential duration (APD) in the atria. Due to the nonuniform distribution of nerve endings, APD dispersion may result, which has been shown to play a role in the breakup of activity. METHODS:Reentry was initiated in a computationally efficient, morphologically realistic computer model of the atria. Discrete regions corresponding to ACh release sites, referred to as islands, were assigned shortened APDs in an ACh-dependent fashion. Island APD was varied as well as the basal APD. The window of vulnerability for ectopic beat-induction of sustained reentry was determined for both left atrial(LA) and right atrial (RA) stimulation. The resulting reentries were categorized based on type and location. RESULTS:1) Atrial geometry severely restricts the formation of reentrant circuits. 2) Wave fractionation only occurred for large differences between island and basal APD. 3) Small ACh concentration differences produced stable figure-of-8 reentrant patterns. 4) Large islands displayed more wave breakup but could sometimes anchor reentries. CONCLUSIONS:Large APD gradients produced by ACh heterogeneity can lead to a breakdown of organized activity.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Vigmond EJ,Tsoi V,Kuo S,Arevalo H,Kneller J,Nattel S,Trayanova N

doi

10.1016/j.hrthm.2004.03.077

keywords:

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

334-44

issue

3

eissn

1547-5271

issn

1556-3871

pii

S1547527104001110

journal_volume

1

pub_type

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