Rotors and the Dynamics of Cardiac Fibrillation
Sandeep V. Pandit,José Jalife +1 more
TLDR
Examination of recent evidence suggesting that rotors are critical in sustaining both atrial and ventricular fibrillation in the human heart and its implications for treatment with radiofrequency ablation is examined.Abstract:
The objective of this article is to present a broad review of the role of cardiac electric rotors and their accompanying spiral waves in the mechanism of cardiac fibrillation. At the outset, we present a brief historical overview regarding reentry and then discuss the basic concepts and terminologies pertaining to rotors and their initiation. Thereafter, the intrinsic properties of rotors and spiral waves, including phase singularities, wavefront curvature, and dominant frequency maps, are discussed. The implications of rotor dynamics for the spatiotemporal organization of fibrillation, independent of the species being studied, are described next. The knowledge gained regarding the role of cardiac structure in the initiation or maintenance of rotors and the ionic bases of spiral waves in the past 2 decades, as well as the significance for drug therapy, is reviewed subsequently. We conclude by examining recent evidence suggesting that rotors are critical in sustaining both atrial and ventricular fibrillation in the human heart and its implications for treatment with radiofrequency ablation.read more
Citations
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Journal ArticleDOI
The role of rotors in atrial fibrillation.
TL;DR: Panoramic contact mapping, incorporating phase analysis, repolarization and conduction dynamics, and oscillations in AF rate, overcomes many prior difficulties with mapping AF and provides evidence that the mechanisms sustaining human AF are deterministic.
Journal ArticleDOI
Renewal Theory as a Universal Quantitative Framework to Characterize Phase Singularity Regeneration in Mammalian Cardiac Fibrillation.
Dhani Dharmaprani,Madeline Schopp,Pawel Kuklik,D. Chapman,Anandaroop Lahiri,Lukah Dykes,Feng Xiong,Martin Aguilar,Benjamin Strauss,Lewis Mitchell,Kenneth J. Pope,Christian Meyer,Stephan Willems,Fadi G. Akar,Stanley Nattel,Andrew D. McGavigan,Andrew D. McGavigan,Anand N. Ganesan,Anand N. Ganesan +18 more
TL;DR: Poisson renewal theory provides an evolutionarily preserved universal framework to quantify formation and destruction of rotational events in cardiac fibrillation.
Journal ArticleDOI
Synergistic Anti-arrhythmic Effects in Human Atria with Combined Use of Sodium Blockers and Acacetin.
TL;DR: This study demonstrates synergistic antiarrhythmic benefits of combined block of IKur and INa, as well as those of INa and combined multi K+-current block of acacetin, without significant alterations of ventricular repolarization and QT intervals.
Journal ArticleDOI
Electrophysiological and structural remodeling in heart failure modulate arrhythmogenesis. 2D simulation study.
TL;DR: Structural remodeling is a key factor in the genesis of vulnerability to reentry under heart failure conditions, and a range of intermediate levels of fibrosis and intercellular uncoupling can combine to favor reentrant activity.
Journal ArticleDOI
Quantitative Profiling of the Effects of Vanoxerine on Human Cardiac Ion Channels and its Application to Cardiac Risk.
Carlos A. Obejero-Paz,Andrew Bruening-Wright,James Kramer,Peter Hawryluk,Milos Tatalovic,Howard C. Dittrich,Arthur M. Brown +6 more
TL;DR: To understand the QT/TdP discordance, quantitative profiling was used and vanoxerine was compared with dofetilide, a selective hERG-blocking torsadogen used for intractable AF, verapamil, a non-torsadogenic MICE comparator and bepridil, one of the MICE drug comparators, consistent with the emphasis on MICE of the CiPA assay.
References
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Journal ArticleDOI
Spontaneous Initiation of Atrial Fibrillation by Ectopic Beats Originating in the Pulmonary Veins
Michel Haïssaguerre,Pierre Jaïs,D. C. Shah,Atsushi Takahashi,Mélèze Hocini,G Quiniou,S. Garrigue,A Le Mouroux,P Le Métayer,Jacques Clementy +9 more
TL;DR: The pulmonary veins are an important source of ectopic beats, initiating frequent paroxysms of atrial fibrillation and these foci respond to treatment with radio-frequency ablation.
Book
Cardiac Electrophysiology : From Cell to Bedside
Douglas P. Zipes,José Jalife +1 more
TL;DR: Part I - Molecular Bases Of Ion Channel Activity PART II - Biophysics and Regulation of Cardiac Ion Channels PART III - Pharmacology of Card cardiac Ion Ch channels PART IV - Cellular Electrophysiology PART V - Models of Cardiopulmonary Excitation PART VI - Neural Control ofCardiac Electrical Activity
Journal ArticleDOI
Excitation-Contraction Coupling and Cardiac Contractile Force.
Donald M. Bers,Yujie Zhu +1 more
TL;DR: The major cellular structures involved in E-C coupling include myofilaments, Na/Ca exchange and the sarcolemmal Ca-pump as mentioned in this paper, as well as the sources and sinks of activator calcium.
Journal ArticleDOI
A dynamic model of the cardiac ventricular action potential. I. Simulations of ionic currents and concentration changes.
Ching-Hsing Luo,Yoram Rudy +1 more
TL;DR: The model provides the basis for the study of arrhythmogenic activity of the single myocyte including afterdepolarizations and triggered activity and can simulate cellular responses under different degrees of Ca2+ overload.
Journal ArticleDOI
A model of the ventricular cardiac action potential. Depolarization, repolarization, and their interaction.
Ching-Hsing Luo,Yoram Rudy +1 more
TL;DR: Simulation of the membrane action potential of the mammalian ventricular cell shows the importance of the slow recovery of INa in determining the response of the cell and relates these phenomena to the underlying ionic channel kinetics.