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Cardiac Bioelectricity Research and Training Center, and Departments of 1 Biomedical Engineering, 2 Physiology and Biophysics, and 3 Medicine, Case Western Reserve University, Cleveland, Ohio 44106-7207
In a sufficiently short reentry pathway, the excitation wave front (head) propagates into tissue that is partially refractory (tail) from the previous action potential (AP). We incorporate a detailed mathematical model of the ventricular myocyte into a one-dimensional closed pathway to investigate the effects of head-tail interaction and ion accumulation on the dynamics of reentry. The results were the following: 1) a high degree of head-tail interaction produces oscillations in several AP properties; 2) Ca2+-transient oscillations are in phase with AP duration oscillations and are often of greater magnitude; 3) as the wave front propagates around the pathway, AP properties undergo periodic spatial oscillations that produce complicated temporal oscillations at a single site; 4) depending on the degree of head-tail interaction, intracellular [Na+] accumulation during reentry either stabilizes or destabilizes reentry; and 5) elevated extracellular [K+] destabilizes reentry by prolonging the tail of postrepolarization refractoriness.
reentry; ion accumulation; alternans; restitution
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