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Titolo:
Mechanisms for discordant alternans
Autore:
Watanabe, MA; Fenton, FH; Evans, SJ; Hastings, HM; Karma, A;
Indirizzi:
Northeastern Univ, Dept Phys, Boston, MA 02115 USA Northeastern Univ Boston MA USA 02115 iv, Dept Phys, Boston, MA 02115 USA Hofstra Univ, Dept Math, Hempstead, NY 11550 USA Hofstra Univ Hempstead NY USA 11550 v, Dept Math, Hempstead, NY 11550 USA Beth Israel Hosp, Dept Cardiol, New York, NY USA Beth Israel Hosp New York NY USA el Hosp, Dept Cardiol, New York, NY USA
Titolo Testata:
JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY
fascicolo: 2, volume: 12, anno: 2001,
pagine: 196 - 206
SICI:
1045-3873(200102)12:2<196:MFDA>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
T-WAVE ALTERNANS; VENTRICULAR-FIBRILLATION; ELECTRICAL ALTERNANS; RESTITUTION PROPERTIES; MYOCARDIUM; VULNERABILITY; ARRHYTHMIAS; INSTABILITY; DYNAMICS;
Keywords:
discordant alternans; T wave alternans; dynamic restitution; restitution;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Karma, A Northeastern Univ, Dept Phys, Dana Bldg, Boston, MA 02115 USA Northeastern Univ Dana Bldg Boston MA USA 02115 ton, MA 02115 USA
Citazione:
M.A. Watanabe et al., "Mechanisms for discordant alternans", J CARD ELEC, 12(2), 2001, pp. 196-206

Abstract

Discordant Altelrnans Mechanism. Introduction: Discordant alternans has the potential to produce larger alternans of the ECG T wave than concordant alternans, but its mechanism is unknown. Methods and Results: We demonstrate by one- and two-dimensional simulationof action potential propagation models that discordant alternans can form spontaneously in spatially homogeneous tissue through one of two mechanisms, due to the interaction of conduction velocity and action potential duration restitution at high pacing frequencies or through the dispersion of diastolic interval produced by ectopic foci. In discordant alternans due to thefirst mechanism, the boundaries marking regions of alternans with oppositephase arise far from the stimulus site, move toward the stimulus site, andstabilize. Dynamic splitting of action potential duration restitution curves due to electrotonic coupling plays a crucial role in this stability. Larger tissues and faster pacing rates are conducive to multiple boundaries, and inhomogeneities of tissue properties facilitate or inhibit formation of boundaries. Conclusion: Spatial inhomogeneities of electrical restitution properties are not required to produce discordant alternans.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/04/20 alle ore 13:26:12