Current Research in Electrocardiology


Restitution Properties and Stability of Rapidly Paced Bullfrog Myocardium

People: S. Sau, D. Gauthier, W. Krassowska Neu, R. Oliver

Collaborators: S. Idriss (Pediatric Cardiology)

Additional information: Quantum Electronics Laboratory Web Page

Summary:
Our most recent study yields experimental evidence that the slope of the dynamic restitution curve does not determine the stability of the response pattern to periodic stimuli. Bullfrog ventricular tissue in vitro was paced at decreasing basic cycle lengths (BCLs). Action potential duration (APD) and the preceding diastolic interval (DI) were measured at each BCL and bifurcation diagrams and restitution curves were drawn. The figure below shows a representative bifurcation diagram from a preparation that exhibits alternans. For all BCLs from 1000 ms to 450 ms, the tissue responds with stable 1:1 behavior. At 425 ms, the bifurcation to alternans occurs followed by aperiodic responses before the transition to 2:1 locking at 350 ms. The slope of the corresponding dynamic restitution curve exceeds one for all DIs less than 250 ms, which corresponds to all BCLs below 850 ms. The slope reaches a maximum of 2.8 just before the bifurcation to alternans (BCL = 425 ms). The slope exceeds one over a wide range of BCLs where the response is 1:1 (50 to 425 ms, span of 425 ms).

The bifurcation pattern seen in the figure(1:1 to 2:2 to 2:1) was seen in 3 of 6 bullfrogs. In all remaining trials, only a 1:1 to 2:1 transition occurred, often with aperiodic responses at the transition BCL. Slope steeper that one during stable 1:1 response was observed in 4 out of 6 animals; in the remaining 2, the maximum slope was below or equal to one. Therefore, our in-vitro experiments demonstrate that the tissue can respond with a stable 1:1 pattern even as the slope of the restitution curve exceeds one, indicating that tissue dynamics is not governed solely by the one-dimensional restitution relationship.

Key Publications:

S. Sau, W. Krassowska, and D. Gauthier, Restitution properties and stability of response patterns in cardiac muscle, Annual APS March Meeting 2002, Indianapolis, IN, p. 948, 2002.

R. A. Oliver and W. Krassowska, Concentration drift and rate-dependent restitution in the CRN atrial membrane model, Annual APS March Meeting 2002, Indianapolis, IN, p. 949, 2002.

Support: NSF Grant NSF-9982860

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Link Between 1:1/2:1 Bistability and Arrhythmogenesis in Sheep Atria

People: R. Oliver, W. Krassowska Neu

Collaborators: D. Gauthier (Physics), P. Wolf (BME), C. Henriquez (BME)

Summary:
This study investigated the response of sheep atria in vivo to rapid pacing. A 504-electrode mapping plaque was affixed to the right atrium in 6 sheep. Cathodal pacing stimuli were delivered to the center of the plaque. The pacing period BCL was decreased from 275 +- 25 ms to 75 +- 25 ms and then increased to 230 +- 70 ms in steps of either 5 or 10 ms. In all 21 trials in 6 sheep, the atrium responded in a 1:1 pattern at longer BCLs and in a 2:1 pattern at shorter BCLs. As the BCL was decreased, the response reverted to 2:1 at a particular BCL. Conversely, as the BCL was increased, the response switched back to 1:1 at a particular BCL. Over 21 trials, the 1:1 to 2:1 and 2:1 to 1:1 transitions occurred at 119.5 +- 18.8 ms and 130.0 +- 19.1 ms, respectively. This hysteretic behavior yielded bistability windows, 10.5 +- 7.2 ms wide, wherein 1:1 and 2:1 responses existed at the same BCL. Combined with the previous study on bullfrog ventricles in vitro (Hall et al., Phys. Rev. Lett., 82: 2995-2998, 1999), these studies imply that bistability occurs in many species, tissue types, and experimental preparations.

In 15 out of 21 trials and in all sheep, idiopathic wavefronts emanating from outside the mapped region passed through the mapped region. In 13 of those trials, the idiopathic wavefronts occurred at BCLs within the bistability window or within 35 ms of its upper or lower limit (figure below). This result suggests a connection between bistability and arrhythmogenesis. We are currently investigating this connection using computer simulations.
Response patterns and idiopathic wavefronts in six sheep. For each animal (numbers on the right), the two horizontal lines show the range of BCLs where the response was 1:1 (upper line) and 2:1 (lower line). Diamonds show BCLs at which idiopathic wavefronts were observed. The leftmost diamonds in animal 6 were associated with the 2:1 to 3:1 transition.

Key Publications:

R. A. Oliver, G. M. Hall, S. Bahar, W. Krassowska, P. D. Wolf, E. Dixon-Tulloch, and D. J. Gauthier, Existence of bistability and correlation with arrhythmogenesis in paced sheep atria, J. Cardiovasc. Electrophysiol., 11: 797-805, 2000.

Support: NSF Grant NSF-9982860 and NC Supercomputing Center

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Send comments to wanda.krassowska@duke.edu
Last updated June 4, 2004