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Next: Defibrillation Up: Re-entrant waves and their Previous: One dimensional vulnerability

Two dimensional phenomena

   figure195
Figure 3: Snapshot of a spiral wave in the OGPV model. Gray-scale shading codes the transmembrane voltage; white is activation and dark is repolarisation. Shown are two isolines, one of the voltage, tex2html_wrap_inline1957 (black curve) and the the other of tex2html_wrap_inline1959 inactivation gate tex2html_wrap_inline1961 (white curve). Crossing of the two isolines is the instant position of the spiral tip (big black circle). The flower-like line made of small white circles is the trajectory of the tip in the last few rotations.

Figure 3 illustrates a spiral wave solution of the model, as the spatial distribution of the membrane potential V, at an instant tex2html_wrap_inline1965 after the spiral wave was initiated by cutting a broken plane wave half way up the medium. The wavefront of the action potential is the sharp transition between light and dark shade, and far from the tip of the spiral the wavelength of the spiral (the distance between successive wavefronts) is about tex2html_wrap_inline1967 . The spiral rotated with an initial period of approximately tex2html_wrap_inline1969 , and over the first tex2html_wrap_inline1971 the period decreased to tex2html_wrap_inline1973 . The tip of the spiral may be defined by the intersection of two isolines; we define the tip by the intersection of the tex2html_wrap_inline1957 and the f=0.5 isolines, where f is the tex2html_wrap_inline1667 (slow inward) current inactivation gating variable. The trajectory of the tip of the spiral is not stationary, but meanders, and its motion is nonuniform, moving by a jump-like alternation between fast and very slow phases, with about 5 jumps per full rotation. This motion resembles an irregular, nearly biperiodic process, with the ratio of the two periods close to 1:5.

The rotation of the spiral wave can be monitored by following an isoline on the wavefront, and the trajectory of the tip of the spiral, as illustrated in Fig. 3. The area enclosed by the tip trajectory is analogous to the core of a rigidly rotating spiral, and is not invaded by the action potential. Characteristics of the V(t) observed at different sites in the medium during the evolution of a rotating spiral wave are (see Fig. 4 or [19] for more detail):

   figure222
Figure 4: Transmembrane voltage recorded inside (a) and outside (b) the core.

These different behaviours occur in an initially homogeneous medium, in which re-entry has established a functional inhomogeneity, and are similar to the behaviours of all functional re-entry waves in excitable medium, and to waves in excitable media rotating around a small obstacle.

Within the functional block or core the membrane potential remains between -45 and tex2html_wrap_inline1987 ; this persistent depolarisation means the inward tex2html_wrap_inline1989 is inactivated, blocking propagation into the core. The principal currents tex2html_wrap_inline1991 far from, and within the core are examined in [19].

After an initial transient, the spiral is rotating around a compact core contained within a few mm square. The multi-lobed pattern of the trajectory of the tip illustrated in Fig. 3 takes time to develop, and itself continues to develop with time. This time evolution, or ``aging'' is described in [19] and has been ascribed to the slow changes in intracellular concentrations that occur in the Oxsoft models.

   figure244
Figure 5: Development and aging of a spiral wave after initiation by phase distribution initial conditions. Two left columns show successive 1- tex2html_wrap_inline1919 \ isochronal maps; the right columns shows corresponding pieces of tip trajectory. Square size tex2html_wrap_inline1993 .

A different approach to examining this aging appears by plotting the voltage isochrones every ms, as in Fig. 5. Here the spiral was initiated from initial conditions specified by the phase distribution method, to prevent any extended structures being produced by the method of initiation of the spiral. Close to the tip of the spiral the distance between the isochrones changes, and so the local wavefront velocity is changing, with slow velocities occurring at the sharp turns of the tip. Bunching of isochronal lines is interpreted as an arc of conduction block in clinical cardiac mapping studies. The spirals initiated from a broken wave and by the cross field technique have more pronounced transients, and their tip evolution is described in [19]. The pattern of the tip motion and the associated velocity of the wavefront near the tip is continually changing, and the early tip trajectory resembles the linear extended tip trajectories seen in the Beeler-Reuter model [25]. However, the slowing down occurs along the linear segments of the trajectory, as well as at the sharp corners.

   figure289
Figure 6: Nonuniformity of propagation velocity around a hole (left column) and in a spiral wave (right column). Top: isochronal map of one rotation with tex2html_wrap_inline1995 step between isochrones. Bottom: variation of propagation velocity with time during the rotation; solid line at the distance tex2html_wrap_inline1997 and the dashed line at tex2html_wrap_inline1999 from the tip along the isochrones. Square size tex2html_wrap_inline1993 .

Girouard et al. [7] have studied propagation of re-entrant waves around a laser induced linear obstacle in the guinea-pig heart. Fig. 6 compares propagation around a thin linear obstacle, with propagation around a functional block. The isochronal maps show the slowed propagation associated with the sharp turns, and the local normal wavefront propagation velocity. For the obstacle, the slowing down is confined to the ends of the obstacle, where the curvature is large, and is consistent with the observations of Girouard et al. [7]. For the functional block there is not a clear connection between the curvature and the velocity.

We believe that around the obstacle, the slowing down is predominantly due to curvature effects, while for the functional block the dominant effect is the propagation of the wavefront into a region of refractory tissue. Although the wavefront, driven only by { tex2html_wrap_inline1931 current, cannot propagate deep into a region where this current is inactivated, tex2html_wrap_inline1667 current can carry the wavefront into refractory region. This is analogous to the interpretation of the onset of irregularity in re-entry in the Beeler-Reuter model as due to interactions between { tex2html_wrap_inline1931 and tex2html_wrap_inline1667 activation fronts [26]. Explicit initiation of { tex2html_wrap_inline1931 and tex2html_wrap_inline1667 propagation fronts in Beeler-Reuter model has been done by Romashko and Starmer [27]; however, direct observation of tex2html_wrap_inline1667 fronts in electrophysiological experiments is difficult as normally both { tex2html_wrap_inline1931 and tex2html_wrap_inline1667 currents are essential for propagation and pure tex2html_wrap_inline1667 fronts occur only in special circumstances and are characterised by lower gradients and propagation speed [28].

   figure337
Figure 7: The role of the two major excitatory currents, tex2html_wrap_inline2003 (left) and tex2html_wrap_inline1959 (right), in forming the shape of the core. Shown are the distribution of the minimal (i.e. maximal in the absolute value) currents throughout the preparation during tex2html_wrap_inline2007 , i.e. slightly longer that one rotation of the spiral wave, same as shown in Fig. 6(b). Vertical axes show values of the currents in nA per cell. Square size tex2html_wrap_inline1993 .

This interpretation can be illustrated by blocking tex2html_wrap_inline1667 -conductance, which removes the extended conduction blocks[26], or by visualising the maximum currents during one rotation. Fig. 7 shows the maximal magnitude of the principal depolarising currents, tex2html_wrap_inline2003 and tex2html_wrap_inline1959 during just over one rotation, the same computation as in Fig. 6(b). While sodium current shows the five-petal star shape of the block (the region where it was nearly zero throughout the rotation), the calcium current has small circular block and only a slight surrounding modulation. Thus, the meandering petals can be interpreted as loci where fast sodium waves died out and propagation was supported by slow calcium waves. The five-lobed pattern is not an attractor, as its shape is continually and slowly changing. However it is persistent for long enough to be considered the state of the spiral wave we would seek to eliminate in section 5; it is important to note that its behaviour and evolution can be understood in terms of the dynamic balancing between the fast and slow depolarising currents, rather than simple curvature and electrotonic loading effects.


next up previous
Next: Defibrillation Up: Re-entrant waves and their Previous: One dimensional vulnerability

Vadim Biktashev
Sun Sep 28 05:44:10 GMT 1997