title: Study of factors affecting the progression and termination of drug induced Torsade de pointes in two dimensional cardiac tissue.
abstract: To study the conditions leading to the initiation and termination of drug induced Torsade de pointes (TdP) along with QT prolongation.
  
  
  
  A 2D anisotropic transmural section of the ventricular myocardium is modeled using the TP06 equations and the cells are interconnected with gap junction conductances (GJC). The tissue is remodeled by reducing the repolarization reserve (by increasing calcium current (ICaL)) of all cells thus making them vulnerable to development of early after depolarizations (EADs).
  
  
  
  Clinical risk conditions like decreased potassium current (IKr), bradycardia, hypokalemia and short-long-short (SLS) triggering sequences are included in the tissue. A pseudo-electrocardiogram is created to realize the intensity of remodeling required in presence of risk factors to initiate TdP. On initiating TdP, the effect of increasing GJC and decreasing ICaLis shown to terminate a non-self-limiting TdP.
  
  
  
  Without the inclusion of underlying increase in ICaLalong with risk factors, TdP cannot be initiated.
authors.affiliation: Biomedical Engineering Group, Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India. Electronic address: kirthipri@gmail.com.
authors.forename: Ponnuraj
authors.initials: P
authors.lastname: Kirthi Priya
authors.affiliation: Biomedical Engineering Group, Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, India. Electronic address: rsreddy@iitm.ac.in.
authors.forename: M Ramasubba
authors.initials: MR
authors.lastname: Reddy
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D003198:Computer Simulation; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology*; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008955:Models, Cardiovascular; D016171:Torsades de Pointes / Q000139:chemically induced* / Q000503:physiopathology*
chemical_list: D000889:Anti-Arrhythmia Agents
keywords: Drug induced QT prolongation; Early after depolarizations; SLS sequence; Torsade de pointes; Ventricular remodeling