Death, dynamics and disorder: Terminating

reentry in excitable media by dynamically-induced

inhomogeneities

 

JOHANNES BREUER1,2 and SITABHRA SINHA1

1The Institute of Mathematical Sciences, CIT Campus, Taramani, Chennai 600 113, India

2Institute of Theoretical Physics, Technical University-Berlin, D-10623 Berlin, Germany

E-mail: sitabhra@imsc.res.in

 

Abstract. Formation of feedback loops of excitation waves (reentrant

circuit) around non-conducting ventricular scar tissue is a

common cause of cardiac arrhythmias, such as ventricular

tachycardia, often leading to death. This is typically

treated by rapid stimulation from an implantable device

(ICD). However, the mechanisms of reentry termination

success and, more importantly, failure, are poorly

understood.  To study such mechanisms, we simulated pacing

termination of reentry in a model of cardiac tissue having

significant restitution and dispersion properties. Our

results show that rapid pacing dynamically generates

conduction inhomogeneities in the reentrant circuit,

leading to successful pacing termination of tachycardia.

The study suggests that more effective pacing algorithms

can be designed by taking into account the role of such

dynamical inhomogeneities.

 

Keywords. Reentry; tachycardia; pacing; disorder.

 

PACS Nos 87.19.Hh; 05.45.Gg; 05.45.-a; 87.10.+e