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- W1972199367 abstract "While arrhythmia incidence is known to increase following coronary occlusion, characterization of transmural events leading to arrhythmogenesis during acute ischemia remains incomplete due to limitations in current experimental techniques. The goal of this modeling research is to elucidate the role of regional ischemia-induced transmural heterogeneities in the ventricles in providing the substrate for reentry over the course of ischemia phase 1A. Methods and Results. We used anatomically accurate bidomain rabbit ventricular model of regional ischemia following LAD occlusion. Ischemic substrate was represented by progressive changes in membrane dynamics due to hyperkalemia, acidosis, and hypoxia corresponding to 2-10 min post-occlusion. The model includes realistic central ischemic zone (CIZ), lateral and endocardial (EBZ) border zones, and transmural IKATP gradient in CIZ (see fig., transmural slice). LV wall was paced at 200 ms basic cycle length and premature stimulation (PS) was applied to RV endocardium at a range of coupling intervals. Results show that PS initiates arrhythmia within 4 to 10min post-occlusion (fig.). Vulnerable window (VW) is widest at 7-8min of ischemia, when refractoriness in normal tissue and CIZ differs the most; arrhythmia induction is then heralded by alternans in EBZ. Within the VW, PS-induced propagation encounters refractory RV and CIZ, while EBZ is already recovered, resulting in reentry (see isochrones in fig.). Halving EBZ decreases safety factor for propagation, resulting in 58.8% decrease in reentry initiation. Omission of transmural CIZ IKATP gradient from the model causes 29.4% increase in arrhythmia initiation due to greater difference in normal vs. CIZ refractoriness. Conclusions. This study provides insight into the contribution of transmural heterogeneities to arrhythmogenesis during regional ischemia phase 1A." @default.
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- W1972199367 date "2005-05-01" @default.
- W1972199367 modified "2023-09-27" @default.
- W1972199367 title "Arrthythmogenicity of transmural heterogeneities in a realistic model of regional ischemia" @default.
- W1972199367 doi "https://doi.org/10.1016/j.hrthm.2005.02.820" @default.
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