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Am J Physiol Heart Circ Physiol (April 11, 2002). doi:10.1152/ajpheart.00898.2001
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Articles in PresS, published online ahead of print April 11, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00898.2001
Submitted on October 16, 2001
Accepted on April 9, 2002

Electrical Refractory Period Restitution and Spiral Wave Reentry in Simulated Cardiac Tissue

Fagen Xie1*, Zhilin Qu1, Alan Garfinkel1, and James N. Weiss1

1 Medicine (Cardiology), University of California at Los Angeles, Los Angeles, CA, USA

* To whom correspondence should be addressed. E-mail: fxie{at}mednet.ucla.edu.

Theoretical and experimental studies have shown that restitution of the cardiac action potential duration (APD) plays a major role in predisposing ventricular tachycardia to degenerate to ventricular fibrillation, whereas its role in atrial fibrillation is unclear. We used the Courtemanche human atrial cell model and Luo-Rudy guinea pig ventricular models to compare the roles of electrical restitution in destabilizing spiral wave reentry in simulated 2-D homogeneous atrial and ventricular tissue. Because atrial action potential morphology is complex, we also validated the usefulness of effective refractory period (ERP) restitution. ERP restitution correlated best with APD-62mV restitution, and its steepness was a reliable predictor of spiral wave phenotype (stable, meandering, hyper-meandering, and breakup) in both atrial and ventricular tissue. Spiral breakup or single hyper-meandering spirals occurred when the slope of ERP restitution exceeded 1 at short diastolic intervals. Thus ERP restitution, which is easier to measure clinically than APD restitution, is a reliable determinant of spiral wave stability in simulated atrial and ventricular tissue.




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