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Bistability and Correlation with Arrhythmogenesis in a Model of the Right Atrium

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Abstract

Rapid pacing is an important tool for understanding cardiac arrhythmias. A recent experiment involving rapid pacing of sheep atria indicated that the initiation of atrial arrhythmias may be related to the 1:1/2:1 bistability. To elucidate the mechanism of this relation, this study applied the pacing protocol from the sheep study to an idealized model of the right atrium. The model included all major anatomical features, the sino-atrial node, and the regional differences in the action potential duration (APD). A pacing protocol was applied, in which the basic cycle length (BCL) was decreased in steps of 10 ms until the response switched to 2:1, then BCL was increased. The 1:1-to-2:1 transitions occurred at shorter BCLs than the 2:1-to-1:1 transitions yielding a global bistability window of 60 ms. As in the sheep study, idiopathic waves were observed at BCLs within or near the bistability window. The model was used to quantify the types, prevalence, and persistence of idiopatic waves, study their initiation and termination, and relate them to the model components. The results demonstrate that idiopatic waveforms move with the shift of the bistability window and that they disappear when bistability is eliminated. Thus, this modeling study supports causal relationship between the 1:1/2:1 bistability and the initiation of arrhythmias.

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Authors and Affiliations

  1. Department of Biomedical Engineering, Duke University, PO Box 90281, Durham, NC, 27708

    Robert A. Oliver, Craig S. Henriquez & Wanda Krassowska

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  1. Robert A. Oliver
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  2. Craig S. Henriquez
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  3. Wanda Krassowska
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Correspondence to Robert A. Oliver.

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Oliver, R.A., Henriquez, C.S. & Krassowska, W. Bistability and Correlation with Arrhythmogenesis in a Model of the Right Atrium. Ann Biomed Eng 33, 577–589 (2005). https://doi.org/10.1007/s10439-005-1473-z

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  • DOI: https://doi.org/10.1007/s10439-005-1473-z

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