Document Detail

The Interrelations among Stochastic Pacing, Stability, and Memory in the Heart.
MedLine Citation:
PMID:  25140438     Owner:  NLM     Status:  In-Data-Review    
Low pacing variabilty in the heart has been clinically reported as a risk factor for lethal cardiac arrhythmias and arrhythmic death. In a previous simulation study, we demonstrated that stochastic pacing sustains an antiarrhythmic effect by moderating the slope of the action potential duration (APD) restitution curve, by reducing the propensity of APD alternans, converting discordant to concordant alternans, and ultimately preventing wavebreaks. However, the dynamic mechanisms relating pacing stochasticity to tissue stability are not yet known. In this work, we develop a mathematical framework to describe the APD signal using an autoregressive stochastic model, and we establish the interrelations between stochastic pacing, cardiac memory, and cardiac stability, as manifested by the degree of APD alternans. Employing stability analysis tools, we show that increased stochasticity in the ventricular tissue activation sequence works to lower the maximal absolute eigenvalues of the stochastic model, thereby contributing to increased stability. We also show that the memory coefficients of the autoregressive model are modulated by pacing stochasticity in a nonlinear, biphasic way, so that for exceedingly high levels of pacing stochasticity, the antiarrhythmic effect is hampered by increasing APD variance. This work may contribute to establishment of an optimal antiarrhythmic pacing protocol in a future study.
Hila Dvir; Sharon Zlochiver
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Biophysical journal     Volume:  107     ISSN:  1542-0086     ISO Abbreviation:  Biophys. J.     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-08-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370626     Medline TA:  Biophys J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1023-34     Citation Subset:  IM    
Copyright Information:
Copyright © 2014 Biophysical Society. Published by Elsevier Inc. All rights reserved.
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