title: Characterizing Spatial Dynamics of Bifurcation to Alternans in Isolated Whole Rabbit Hearts Based on Alternate Pacing.
abstract: Sudden cardiac death instigated by ventricular fibrillation (VF) is the largest cause of natural death in the USA. Alternans, a beat-to-beat alternation in the action potential duration, has been implicated as being proarrhythmic. The onset of alternans is mediated via a bifurcation, which may occur through either a smooth or a border-collision mechanism. The objective of this study was to characterize the mechanism of bifurcation to alternans based on experiments in isolated whole rabbit hearts. High resolution optical mapping was performed and the electrical activity was recorded from the left ventricle (LV) epicardial surface of the heart. Each heart was paced using an "alternate pacing protocol," where the basic cycle length (BCL) was alternatively perturbed by ±δ. Local onset of alternans in the heart, BCL(start), was measured in the absence of perturbations (δ = 0) and was defined as the BCL at which 10% of LV exhibited alternans. The influences of perturbation size were investigated at two BCLs: one prior to BCL(start) (BCL(prior) = BCL(start) + 20 ms) and one preceding BCL(prior) (BCL(far) = BCL(start) + 40 ms). Our results demonstrate significant spatial correlation of the region exhibiting alternans with smooth bifurcation characteristics, indicating that transition to alternans in isolated rabbit hearts occurs predominantly through smooth bifurcation.
authors.affiliation: Department of Biomedical Engineering, University of Minnesota, 312 Church Street SE, Minneapolis, MN 55455, USA.
authors.forename: Kanchan
authors.initials: K
authors.lastname: Kulkarni
authors.affiliation: Department of Biomedical Engineering, University of Minnesota, 312 Church Street SE, Minneapolis, MN 55455, USA.
authors.forename: Ramjay
authors.initials: R
authors.lastname: Visweswaran
authors.affiliation: Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, 1506 Middle Drive, Knoxville, TN 37996, USA.
authors.forename: Xiaopeng
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Biomedical Engineering, University of Minnesota, 312 Church Street SE, Minneapolis, MN 55455, USA.
authors.forename: Elena G
authors.initials: EG
authors.lastname: Tolkacheva
mesh_terms: D000200:Action Potentials / Q000502:physiology*; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D000067268:Isolated Heart Preparation; D010477:Perfusion; D011817:Rabbits; D014693:Ventricular Fibrillation / Q000503:physiopathology*; D056969:Voltage-Sensitive Dye Imaging