title: Control of cardiac alternans in an electromechanical model of cardiac tissue.
abstract: Electrical alternations in cardiac action potential duration have been shown to be a precursor to arrhythmias and sudden cardiac death. Through the mechanism of excitation-contraction coupling, the presence of electrical alternans induces alternations in the heart muscle contractile activity. Also, contraction of cardiac tissue affects the process of cardiac electric wave propagation through the mechanism of the so-called mechanoelectrical feedback. Electrical excitation and contraction of cardiac tissue can be linked by an electromechanical model such as the Nash-Panfilov model. In this work, we explore the feasibility of suppressing cardiac alternans in the Nash-Panfilov model which is employed for small and large deformations. Several electrical pacing and mechanical perturbation feedback strategies are considered to demonstrate successful suppression of alternans on a one-dimensional cable. This is the first attempt to combine electrophysiologically relevant cardiac models of electrical wave propagation and contractility of cardiac tissue in a synergistic effort to suppress cardiac alternans. Numerical examples are provided to illustrate the feasibility and the effects of the proposed algorithms to suppress cardiac alternans.
authors.affiliation: Department of Biomedical Engineering, University of Alberta, Edmonton, AB Canada T6G 2V2.
authors.forename: Azzam
authors.initials: A
authors.lastname: Hazim
authors.affiliation: Department of Biomedical Engineering, Department of Mathematics and Campus Saint-Jean, University of Alberta, AB Canada T6C 4G9.
authors.forename: Youssef
authors.initials: Y
authors.lastname: Belhamadia
authors.affiliation: Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB Canada T6G 2V4. Electronic address: Stevan.Dubljevic@ualberta.ca.
authors.forename: Stevan
authors.initials: S
authors.lastname: Dubljevic
mesh_terms: D000465:Algorithms; D055724:Electrophysiological Phenomena / Q000502:physiology*; D006801:Humans; D008955:Models, Cardiovascular; D009200:Myocardial Contraction / Q000502:physiology*; D009206:Myocardium
keywords: Action potential; Alternans control; Electrical alternans; Mechanical perturbation; Nash–Panfilov model; Pacing periods