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Am J Physiol Heart Circ Physiol 280: H1667-H1673, 2001;
0363-6135/01 $5.00
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Vol. 280, Issue 4, H1667-H1673, April 2001

Effects of simulated ischemia on spiral wave stability

Fagen Xie, Zhilin Qu, Alan Garfinkel, and James N. Weiss

Cardiovascular Research Laboratory, Departments of Medicine (Cardiology) and Physiological Science, University of California at Los Angeles School of Medicine, Los Angeles, California 90095

Regional hyperkalemia during acute myocardial ischemia is a major factor promoting electrophysiological abnormalities leading to ventricular fibrillation (VF). However, steep action potential duration restitution, recently proposed to be a major determinant of VF, is typically decreased rather than increased by hyperkalemia and acute ischemia. To investigate this apparent contradiction, we simulated the effects of regional hyperkalemia and other ischemic components (anoxia and acidosis) on the stability of spiral wave reentry in simulated two-dimensional cardiac tissue by use of the Luo-Rudy ventricular action potential model. We found that the hyperkalemic "ischemic" area promotes wavebreak in the surrounding normal tissue by accelerating the rate of spiral wave reentry, even after the depolarized ischemic area itself has become unexcitable. Furthermore, wavebreak and fibrillation can be prevented if the dynamical instability of the normal tissue is reduced significantly by targeting electrical restitution properties, suggesting a novel therapeutic approach.

myocardial ischemia; spiral wave reentry; ventricular arrhythmias; hyperkalemia


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