Rotational Activity around an Obstacle in 2D Cardiac Tissue in Presence of Cellular Heterogeneity

Waves of electrical excitation rotating around an obstacle is one of the important mechanisms of dangerous cardiac arrhythmias occurring in the heart damaged by a post-infarction scar. Such a scar is also surrounded by the region of heterogeneity called a gray zone. In this paper, we perform the first comprehensive numerical study of various regimes of wave rotation around an obstacle surrounded by a gray zone. We use the TP06 cellular ionic model for human cardiomyocytes and study how the period and the pattern of wave rotation depend on the radius of a circular obstacle and the width of a circular gray zone. Our main conclusions are the following. The wave rotation regimes can be subdivided into three main classes: (1) functional rotation, (2) scar rotation and the newly found (3) gray zone rotation regimes. In the scar rotation regime, the wave rotates around the obstacle, while in the gray zone regime, the wave rotates around the gray zone. As a result, the period of rotation is determined by the perimeter of the scar, or gray zone perimeter correspondingly. The transition from the scar to the gray rotation regimes can be determined from the minimal period principle, formulated in this paper. We have also observed additional regimes associated with two types of dynamical instabilities which may affect or not affect the period of rotation. The results of this study can help to identify the factors determining the period of arrhythmias in post-infarction patients.

Rotational Activity Around an Obstacle in 2D Cardiac Tissue in Presence of Cellular Heterogeneity

Waves of electrical excitation rotating around an obstacle is one of the important mechanisms of dangerous cardiac arrhythmias occurring in the heart damaged by post-infarction scar. Such a scar also has a border zone around it, which has electrophysiological properties different from the rest of normal myocardial tissue. Spatial patterns of wave rotation in the presence of such tissue heterogeneity are poorly studied. In this paper we perform a comprehensive numerical study of various regimes of rotation of a wave in a plane layer of the ventricular tissue around an obstacle surrounded by a gray zone. We use a TP06 cellular ionic model which reproduces the electrophysiological properties cardiomyocytes in the left ventricle of human heart. We vary the extent of obstacle and gray zone and study the pattern of wave rotation and its period. We observed different regimes of wave rotation that can be subdivided into several classes: (1) functional rotation and (2) scar rotation regimes, which were identified in the previous studies, and new (3) gray zone rotation regime: where the wave instead of rotation around the obstacle, rotates around the gray zone (an area of tissue heterogeneity) itself. For each class, the period of rotation is determined by different factors, which we discuss and quantify. We also found that due to regional pathological remodeling of myocardial tissue, we can obtain additional regimes associated with dynamical instabilities of two types which may affect or not affect the period of rotation.

Drift of scroll waves of electrical excitation in an isotropic model of the cardiac left ventricle

The dynamics of scroll waves in a symmetric isotropic model of the human cardiac left ventricle is considered. The position of the attractor and the wave rotation velocity over the attractor were determined depending on the wall thickness, parameters of the cell model, chirality of the wave, and the initial position. Mechanisms of observed phenomena are discussed.