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1 Medicine, University of California, Los Angeles, CA, USA
* To whom correspondence should be addressed. E-mail: zqu{at}mednet.ucla.edu.
Na+ channel and K+ channel blocking drugs have both anti- and pro-arrhythmic effects. Their effects during fibrillation, however, remain poorly understood. We used computer simulation of two-dimensional (2D) structurally normal tissue model with phase I of the Luo and Rudy action potential model to study the effects of Na+ and K+ channel blockade on vulnerability to and termination of reentry in simulated multiple wavelet and mother rotor fibrillation. The main findings are: 1) Na+ channel blockade decreased, while K+ channel blockade increased, the vulnerable window of reentry in heterogeneous 2D tissue, due to their opposing effects on dynamical wave instability. 2) Na+ channel blockade increased the cycle length of reentry more than it increased refractoriness. In multiple wavelet fibrillation, Na+ channel blockade first increased and then decreased the average duration or transient time <Ts> of fibrillation. In mother rotor fibrillation, Na+ channel blockade caused peripheral fibrillatory conduction block to resolve and the mother rotor to drift, leading either to self-termination or sustained tachycardia. 3) K+ channel blockade increased dynamical instability by steepening action potential duration restitution. In multiple wavelet fibrillation, this effect shortened <Ts> due to enhanced wave instability. In mother rotor fibrillation, this effect converted mother rotor fibrillation into multiple wavelet fibrillation, which then could self-terminate. Our findings help to illuminate, from a theoretical perspective, the possible underlying mechanisms of termination of different types of fibrillation by antiarrhythmic drugs.
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