Cardiac dynamics: Alternans and arrhythmogenesis

Journal of Arrhythmia

卷:32

Vivian Tse¹  Jie Ming Yeo, MBBS BSc²  Sheung Ting Wong, BSc²  Hiu Yu Lin³  Yee Ting Lee³  Gary Tse, BA Hons MBBS MA PhD³ 

[1] Department of Physiology, McGill University, Canada;

[2] Faculty of Medicine, Imperial College London, SW7 2AZ London, UK;

[3] School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong;

关键词: Cardiac arrhythmia;    Dynamics;    Re-entry;    Restitution;    Alternans;   

DOI  :  10.1016/j.joa.2016.02.009

来源: DOAJ

【 摘 要 】

Pre-existing heterogeneities present in cardiac tissue are essential for maintaining the normal electrical and mechanical functions of the heart. Exacerbation of such heterogeneities or the emergence of dynamic factors can produce repolarization alternans, which are beat-to-beat alternations in the action potential time course. Traditionally, this was explained by restitution, but additional factors, such as cardiac memory, calcium handling dynamics, refractory period restitution, and mechano-electric feedback, are increasingly recognized as the underlying causes. The aim of this article is to review the mechanisms that generate cardiac repolarization alternans and convert spatially concordant alternans to the more arrhythmogenic spatially discordant alternans. This is followed by a discussion on how alternans generate arrhythmias in a number of clinical scenarios, and concluded by an outline of future therapeutic targets for anti-arrhythmic therapy.

【 授权许可】

Unknown