title: Sublimation-like Behavior of Cardiac Dynamics in Heart Failure: A Malignant Phase Transition?
abstract: An abrupt transition from sinus cardiac rhythm to atrial fibrillation (AF) is common in patients with chronic heart failure (CHF). We propose a conceptual framework for viewing this malignant transition in terms of a type of sublimation marked by the switch from highly periodic sinus interbeat interval dynamics characteristic of CHF to a state of random disorganization with AF. Sublimation of physical substances involves an increase in entropy via heat transfer. In contrast, the disease-related sublimation-like behavior involves a loss of information content, associated decreases in cardiac bioenergetic capacity and in multiscale entropy.
authors.affiliation: Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02115, USA.
authors.forename: Ary L
authors.initials: AL
authors.lastname: Goldberger
authors.affiliation: Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02115, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Henriques
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, MA, 02115 USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Mariani
keywords: atrial fibrillation; entropy; heart failure; phase transition; sublimation