ArticlePloS one2014
Structural heterogeneity modulates effective refractory period: a mechanism of focal arrhythmia initiation.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
14 citing papers in PubMed, 21 citations in OpenAlex.
- Impact of effective refractory period personalization on arrhythmia vulnerability in patient-specific atrial computer models.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Initiation of ventricular arrhythmia in the acquired long QT syndrome.Cardiovascular research · 2023Article
- Calibrating cardiac electrophysiology models using latent Gaussian processes on atrial manifolds.Scientific reports · 2022Article
- Electrophysiological and Structural Remodeling of the Atria in a Mouse Model of Troponin-I Mutation Linked Hypertrophic Cardiomyopathy: Implications for Atrial Fibrillation.International journal of molecular sciences · 2021Article
- Right ventricular insertion promotes reinitiation of ventricular fibrillation in defibrillation failure.Heart rhythm · 2021Article
- Arrhythmogenic effects of ultra-long and bistable cardiac action potentials.PLoS computational biology · 2021Article
- Ventricular Endocardial Tissue Geometry Affects Stimulus Threshold and Effective Refractory Period.Biophysical journal · 2018Article
- Mathematical Analysis of the Role of Heterogeneous Distribution of Excitable and Non-excitable Cells on Early Afterdepolarizations.Frontiers in physics · 2018Article
- Bidomain Predictions of Virtual Electrode-Induced Make and Break Excitations around Blood Vessels.Frontiers in bioengineering and biotechnology · 2017Article
- Cardiac dynamics: Alternans and arrhythmogenesis.Journal of arrhythmia · 2016Review
- Computational Representations of Myocardial Infarct Scars and Implications for Arrhythmogenesis.Clinical Medicine Insights. Cardiology · 2016Review
- Local Gradients in Electrotonic Loading Modulate the Local Effective Refractory Period: Implications for Arrhythmogenesis in the Infarct Border Zone.IEEE transactions on bio-medical engineering · 2015Article
- Myocardial electrotonic response to submaximal exercise in dogs with healed myocardial infarctions: evidence for β-adrenoceptor mediated enhanced coupling during exercise testing.Frontiers in physiology · 2015Article
- From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery.Journal of atrial fibrillationReview
Corrections and comments
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Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
Reductions in electrotonic loading around regions of structural and electrophysiological heterogeneity may facilitate capture of focal triggered activity, initiating reentrant arrhythmias. How electrotonic loading, refractoriness and capture of focal ectopics depend upon the intricate nature of physiological structural anatomy, as well as pathological tissue remodelling, however, is not well understood. In this study, we performed computational bidomain simulations with anatomically-detailed models representing the rabbit left ventricle. We used these models to quantify the relationship between local structural anatomy and spatial heterogeneity in action potential (AP) characteristics, electrotonic currents and effective refractory periods (ERPs) under pacing and restitution protocols. Regions surrounding vessel cavities, in addition to tissue surfaces, had significantly lower peak downstream electrotonic currents than well coupled myocardium (72.6 vs 220.4 μA/cm2), with faster maximum AP upstroke velocities (257.3 vs 147.3 mV/ms), although noticeably very similar APDs (167.7 vs 168.4 ms) and AP restitution properties. Despite similarities in APDs, ERPs in regions of low electrotonic load in the vicinity of surfaces, intramural vessel cavities and endocardial structures were up to 40 ms shorter compared to neighbouring well-coupled tissue, leading to regions of sharp ERP gradients. Consequently, focal extra-stimuli timed within this window of ERP heterogeneity between neighbouring regions readily induced uni-directional block, inducing reentry. Most effective induction sites were within channels of low ERPs between large vessels and epicardium. Significant differences in ERP driven by reductions in electrotonic loading due to fine-scale physiological structural heterogeneity provides an important mechanism of capture of focal activity and reentry induction. Application to pathological ventricles, particularly myocardial infarction, will have important implications in anti-arrhythmia therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.