title: Global alternans instability and its effect on non-linear wave propagation: dynamical Wenckebach block and self terminating spiral waves.
abstract: The main mechanism of formation of reentrant cardiac arrhythmias is via formation of waveblocks at heterogeneities of cardiac tissue. We report that heterogeneity and the area of waveblock can extend itself in space and can result formation of new additional sources, or termination of existing sources of arrhythmias. This effect is based on a new form of instability, which we coin as global alternans instability (GAI). GAI is closely related to the so-called (discordant) alternans instability, however its onset is determined by the global properties of the APD-restitution curve and not by its slope. The APD-restitution curve relates the duration of the cardiac pulse (APD) to the time interval between the pulses, and can easily be measured in an experimental or even clinical setting. We formulate the conditions for the onset of GAI, study its manifestation in various 1D and 2D situations and discuss its importance for the onset of cardiac arrhythmias.
authors.affiliation: Department of Physics and Astronomy, Ghent University, Krijgslaan 281, S9, 9000 Ghent, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Vandersickel
authors.affiliation: Department of Physics and Astronomy, Ghent University, Krijgslaan 281, S9, 9000 Ghent, Belgium.
authors.forename: Arne
authors.initials: A
authors.lastname: Defauw
authors.affiliation: Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Krijgslaan 281, S9, 9000 Ghent, Belgium.
authors.forename: Peter
authors.initials: P
authors.lastname: Dawyndt
authors.affiliation: Department of Physics and Astronomy, Ghent University, Krijgslaan 281, S9, 9000 Ghent, Belgium.|Moscow Institute of Physics and Technology (State University) Dolgoprudny, Moscow Region, Russia.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Panfilov
mesh_terms: D000200:Action Potentials; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D017711:Nonlinear Dynamics