Spontaneous spiral wave breakup caused by pinning to the tissue defect

The work presents a mechanism of spiral wave initiation due to the specific boundary conditions on a border of cardiac tissue defect. There are known scenarios when anatomical or functional defects in cardiac tissue may provoke the spiral wave origination, including unidirectional blockage while passing through the narrow gates, bent over critical curvature wave fronts, inhomogeneous recovery of the tissue, etc. We show a new scenario of spiral wave breakup on a small defect, which is unexcitable but permeable for ionic currents supporting the excitation wave. It was believed that such defects stabilize the rotating wave; however, as shown, instead of stabilizing it leads to the spiral breakup and subsequent multiplication of the rotating waves.     

Multiple mechanisms of spiral wave breakup in a model of cardiac electrical activity

It has become widely accepted that the most dangerous cardiac arrhythmias are due to reentrant waves, i.e., electrical wave(s) that recirculate repeatedly throughout the tissue at a higher frequency than the waves produced by the heart's natural pacemaker (sinoatrial node). However, the complicated structure of cardiac tissue, as well as the complex ionic currents in the cell, have made it extremely difficult to pinpoint the detailed dynamics of these life-threatening reentrant arrhythmias. A simplified ionic model of the cardiac action potential (AP), which can be fitted to a wide variety of experimentally and numerically obtained mesoscopic characteristics of cardiac tissue such as AP shape and restitution of AP duration and conduction velocity, is used to explain many different mechanisms of spiral wave breakup which in principle can occur in cardiac tissue. Some, but not all, of these mechanisms have been observed before using other models; therefore, the purpose of this paper is to demonstrate them using just one framework model and to explain the different parameter regimes or physiological properties necessary for each mechanism (such as high or low excitability, corresponding to normal or ischemic tissue, spiral tip trajectory types, and tissue structures such as rotational anisotropy and periodic boundary conditions). Each mechanism is compared with data from other ionic models or experiments to illustrate that they are not model-specific phenomena. Movies showing all the breakup mechanisms are available at http://arrhythmia.hofstra.edu/breakup and at ftp://ftp.aip.org/epaps/chaos/E-CHAOEH-12-039203/ INDEX.html. The fact that many different breakup mechanisms exist has important implications for antiarrhythmic drug design and for comparisons of fibrillation experiments using different species, electromechanical uncoupling drugs, and initiation protocols. (c) 2002 American Institute of Physics.     

Mechanism for spiral wave breakup in excitable and oscillatory media

We study spiral wave breakup using a Fitzhugh-Nagumo-type system. We find that spiral wave breakup can occur near the core or far from it in both excitable and oscillatory regimes. There is a faraway breakup scenario in both excitable and oscillatory media that depends on long wavelength modulation modes. We observed three distinct scenarios, including one that involves breakup that does not develop into turbulence. However, we find that the mechanisms behind these three scenarios are the same: they are caused by the interaction between the dispersion relation and the asymptotic behavior of the modulation mode. The difference in phenomenology is due to the asymptotic behavior of the modulation mode.     

Instability and spatiotemporal dynamics of alternans in paced cardiac tissue

We derive an equation that governs the spatiotemporal dynamics of small amplitude alternans in paced cardiac tissue. We show that a pattern-forming linear instability leads to the spontaneous formation of stationary or traveling waves whose nodes divide the tissue into regions with opposite phase of oscillation of action potential duration. This instability is important because it creates dynamically a heterogeneous electrical substrate for the formation of conduction blocks and the induction of fibrillation if the tissue size exceeds a fraction of the pattern wavelength. We derive an analytical expression for this wavelength as a function of three basic length scales related to dispersion and intercellular electrical coupling.     

Robustness and breakup of the spiral wave in a two-dimensional lattice network of neurons

The robustness and breakup of spiral wave in a two-dimensional lattice networks of neurons are investigated. The effect of small- world type connection is often simplified with local regular connection and the long-range connection with certain probability. The network effect on the development of spiral wave can be better described by local regular connection and changeable long-range connection probability than fixed long-range connection probability because the long-range probability could be changeable ...     

Unidirectional pinning and hysteresis of spatially discordant alternans in cardiac tissue

Spatially discordant alternans is a widely observed pattern of voltage and calcium signals in cardiac tissue that can precipitate lethal cardiac arrhythmia. Using spatially coupled iterative maps of the beat-to-beat dynamics, we explore this pattern's dynamics in the regime of a calcium-dominated period-doubling instability at the single-cell level. We find a novel nonlinear bifurcation associated with the formation of a discontinuous jump in the amplitude of calcium alternans at nodes separating discordant regions. We show that this jump unidirectionally pins nodes by preventing their motion away from the pacing site following a pacing rate decrease but permitting motion towards this site following a rate increase. This unidirectional pinning leads to strongly history-dependent node motion that is strongly arrhythmogenic.     

Termination of spiral wave breakup in a Fitzhugh-Nagumo model via short and long duration stimuli

Rotating spiral waves have been observed in a variety of nonlinear biological and physical systems. Spiral waves are found in excitable and oscillatory systems and can be stationary, meander, or even degenerate into multiple unstable rotating waves (a process called "spiral wave breakup"). In the heart, spiral wave breakup is thought to be the underlying mechanism of cardiac fibrillation. The spatiotemporal complexity of multiple unstable spiral waves is difficult to control or terminate. Here, the mechanisms of the termination of spiral wave breakup in response to global stimulation are investigated. A modified Fitzhugh-Nagumo model was used to represent cellular kinetics to study the role of the fast (activation) and slow (recovery) variables. This simplified model allows a theoretical analysis of the termination of spiral wave breakup via both short and long duration pulses. Simulations were carried out in both two-dimensional sheets and in a three-dimensional geometry of the heart ventricles. The short duration pulses affected only the fast variable and acted to reset wave propagation. Monophasic pulses excited tissue ahead of the wave front thus reducing the amount of excitable tissue. Biphasic shocks did the same, but they also acted to generate new wave fronts from the pre-existing wave tails by making some active regions excitable. Thus, if the short duration stimuli were strong enough, they acted to fill in excitable tissue via propagating wave fronts and terminated all activity. The long duration wave forms were selected such that they had a frequency spectrum similar to that of the pseudoelectrocardiograms recorded during fibrillation. These long duration wave forms affected both the recovery and activation variables, and the mechanism of unstable multiple spiral wave termination was different compared to the short duration wave forms. If the long duration stimuli were strong enough, they acted to alter the "state" (i.e., combination of fast and slow variables) of the tissue throughout 1.5 cycles, thus "conditioning" the tissue such that by the end of the stimuli almost no excitable tissue remained. The peak current, total energy, and average power of stimuli required to terminate spiral wave breakup were less for the long duration wave forms compared to the short duration wave forms. In addition, closed loop feedback via stimulation with a wave form that was the difference of the pseudoelectrocardiogram and a strongly periodic chaotic signal was successful at terminating spiral wave breakup. These results suggest that it may be possible to improve cardiac defibrillation efficacy by using long duration wave forms to affect recovery variables in the heart as opposed to the traditional brief duration wave forms that act only on the fast variables. (c) 2002 American Institute of Physics.     

Success of spiral wave unpinning from heterogeneity in a cardiac tissue depends on its boundary conditions

The mechanism of the low voltage defibrillation is based on the drift of the spiral wave induced by a high frequency wave train. In the process, it is first necessary to unpin the wave from the stabilizing obstacle. We study the conditions of unpinning of a rotating wave anchored to the defect by posing the main accent on the boundary conditions of it. The computer simulations performed using the Korhonen model showed that the fluxes through the border of the defect in the cardiac tissue can significantly modify the excitation pattern, and the working frequency gap for the unpinning of reentry waves could be substantially reduced, making overdrive pacing procedure less effective or practically inapplicable.     

New approach to the defibrillation problem: Suppression of the spiral wave activity of cardiac tissue

A model of an excitable medium is considered for describing the development of fibrillation (i.e., spatiotemporal chaos) in cardiac tissue through the generation of a set of coexisting spiral waves. It is shown that a weak external point action on such a medium leads to the suppression of all spiral waves and, correspondingly, to the stabilization of the system dynamics. After reaching the regular regime, only the external source exists in the medium. The frequencies and amplitudes at which such stabilization occurs are determined. The case of the action of several point sources is considered. Analysis is performed using the Bray method to identify the number of spiral waves.     

Spatiotemporal control of cardiac alternans

Electrical alternans are believed to be linked to the onset of life-threatening ventricular arrhythmias and sudden cardiac death. Recent studies have shown that alternans can be suppressed temporally by dynamic feedback control of the pacing interval. Here we investigate theoretically whether control can suppress alternans both temporally and spatially in homogeneous tissue paced at a single site. We first carry out ionic model simulations in a one-dimensional cable geometry which show that control is only effective up to a maximum cable length that decreases sharply away from the alternans bifurcation point. We then explain this finding by a linear stability analysis of an amplitude equation that describes the spatiotemporal evolution of alternans. This analysis reveals that control failure above a critical cable length is caused by the formation of standing wave patterns of alternans that are eigenfunctions of a forced Helmholtz equation, and therefore remarkably analogous to sound harmonics in an open pipe. We discuss the implications of these results for using control to suppress alternans in the human ventricles as well as to probe fundamental aspects of alternans morphogenesis. (c) 2002 American Institute of Physics.     

Period-doubling bifurcation to alternans in paced cardiac tissue: crossover from smooth to border-collision characteristics

We investigate, both experimentally and theoretically, the period-doubling bifurcation to alternans in heart tissue. Previously, this phenomenon has been modeled with either smooth or border-collision dynamics. Using a modification of existing experimental techniques, we find a hybrid behavior: Very close to the bifurcation point, the dynamics is smooth, whereas further away it is border-collision-like. The essence of this behavior is captured by a model that exhibits what we call an unfolded border-collision bifurcation. This new model elucidates that, in an experiment, where only a limited number of data points can be measured, the smooth behavior of the bifurcation can easily be missed.     

Experimental studies on long-wavelength instability and spiral breakup in a reaction-diffusion system

We investigate the behavior of spiral waves in a quasi-two-dimensional spatial open reactor using Belousov-Zhabotinsky reaction. The goal of this study is to answer two questions raised recently: Can a system sustain a stable long-wavelength modulated spiral? What causes the transition from spiral to defect-mediated turbulence? Our experimental results show that in a certain range of control parameters, a sustained long-wavelength modulated spiral is stable. The amplitude and the wavelength of modulations increase with the control parameter. As the latter is increased to across a threshold, defects are generated far away from the spiral center as a result of the neighboring two wave fronts being too close.     

Experimental control of cardiac muscle alternans

We demonstrate that alternans in small pieces of in vitro paced bullfrog (Rana Catesbeiana) myocardium can be suppressed by making minute adjustments to the pacing period in response to real time measurements of the action potential duration. Control is possible over a large range of physiological conditions over many animals and the self-referencing control protocol can automatically adjust to changes in the pacing interval. Our results suggest the feasibility of developing low-energy methods for maintaining normal cardiac function.     

Complex spiral wave dynamics in a spatially distributed ionic model of cardiac electrical activity

This study presents computations and analysis of the dynamics of reentrant spiral waves in a realistic model of cardiac electrical activity, incorporating the Beeler-Reuter equations into a two-dimensional cable model. In this medium, spiral waves spontaneously break up, but may be stabilized by shortening the excitation pulse duration through an acceleration of the dynamics of the calcium current. We describe the breakup of reentrant waves based on the presence of slow recovery fronts within the medium. This concept is introduced using examples from pulse circulation around a ring and extended to two-dimensional propagation. We define properties of the restitution and dispersion relations that are associated with slow recovery fronts and promote spiral breakup. The role of slow recovery fronts is illustrated with concrete examples from numerical simulations. (c) 1996 American Institute of Physics.     

Mechanisms for initiation of cardiac discordant alternans

Electrical alternans, defined as a beat-to-beat change in the duration of the excited phase of cardiac cells, is among the known precursors of sudden cardiac death. It may appear as concordant (all the tissue presenting the same phase of oscillation) or discordant (with out-of-phase regions distributed among tissue). Spatially discordant alternans can lead to unidirectional block that initiates reentry and ventricular fibrillation. The role played by tissue heterogeneities and heart rate changes in their initiation remains, however, unclear. We study the mechanisms for initiation of spatially discordant alternans by numerical simulations of an ionic model spatially distributed in a one-dimensional cable and in an anatomical model of the rabbit heart. The effects of CV-restitution, ectopic beats, and the role of spatial gradients of electrical restitution properties are investigated. In homogeneous tissue, the origin of discordant alternans may be dynamical, through CV-restitution, or due to a localized change in the pacing period. We also find that a sudden change of stimulation rate can initiate discordant alternans in the presence of a spatial gradient of APD-restitution without necessitating CV-restitution. The mechanism of, and the conditions for, initiation are determined based on an iterated map analysis of beat to beat changes of APD. This analysis leads to the definition of a vulnerable window for initiation of discordant alternans. Moreover, the pattern of spatially discordant alternans is found to change slowly over several beats following initiation, as reflected in ECG recordings.     

Covariant stringlike dynamics of scroll wave filaments in anisotropic cardiac tissue

It has been hypothesized that stationary scroll wave filaments in cardiac tissue describe a geodesic in a curved space whose metric is the inverse diffusion tensor. Several numerical studies support this hypothesis, but no analytical proof has been provided yet for general anisotropy. In this Letter, we derive dynamic equations for the filament in the case of general anisotropy. These equations are covariant under general spatial coordinate transformations and describe the motion of a stringlike object in a curved space whose metric tensor is the inverse diffusion tensor. Therefore the behavior of scroll wave filaments in excitable media with anisotropy is similar to the one of cosmic strings in a curved universe. Our dynamic equations are valid for thin filaments and for general anisotropy. We show that stationary filaments obey the geodesic equation.     

Spray impingement wall film breakup by wave entrainment

Fuel spray impingement on engine wall and piston in the spark-ignition direct-injection (SIDI) setting has been considered a major concern in the aspect of engine emission and combustion efficiency. Excess wall film will result in deterioration of engine friction, incomplete combustion, and substantial cycle-to-cycle variations. These effects are more pronounced during engine cold-start process. Therefore, the formation of wall film on engine wall/piston and the dynamic process of the wall film interacting with impinging spray and spray-induced gas flow are of great significance for reducing wall film mass. However, the dynamic process of wall film was not investigated thoroughly in existing literatures. This work will present a high-speed, simultaneous measurement of a single-hole spray structure, as well as wall film geometry and thickness, via Mie scattering and volumetric laser-induced fluorescence, respectively. Quantitative film thickness measurement was achieved via fluorescence intensity signal calibration with a known, wedge-shape liquid film apparatus. Remarkable wall film droplet entrainment at the leading edge of the liquid film waves was revealed in the measurement, which has not been adequately depicted or analyzed in existing spray impingement studies. A considerable amount of liquid droplets detaches from the liquid film via liquid film fingering, during which process the quantity of liquid mass on the wall is decreased. Quantitative analysis of such phenomenon is performed and we estimated that a liquid mass equivalent to 30–40% of the residual liquid film mass is detached from the liquid film via wave entrainment. Furthermore, through the comparative study of the side view of the spray and the liquid film caused by spray impingement, it is shown that non-uniform spray structure is likely the cause of liquid film wavy motions. These observations suggest that wave entrainment should be considered by numerical models and experimental designs to accurately predict spray impingement phenomenon.     

Control of electrical alternans in canine cardiac purkinje fibers

Alternation in the duration of consecutive cardiac action potentials (electrical alternans) may precipitate conduction block and the onset of arrhythmias. Consequently, suppression of alternans using properly timed premature stimuli may be antiarrhythmic. To determine the extent to which alternans control can be achieved in cardiac tissue, isolated canine Purkinje fibers were paced from one end using a feedback control method. Spatially uniform control of alternans was possible when alternans amplitude was small. However, control became attenuated spatially as alternans amplitude increased. The amplitude variation along the cable was well described by a theoretically expected standing wave profile that corresponds to the first quantized mode of the one-dimensional Helmholtz equation. These results confirm the wavelike nature of alternans and may have important implications for their control using electrical stimuli.