Using noise to determine cardiac restitution with memory

Dai, Shu; Keener, James P.

doi:10.1103/physreve.85.061902

Cited by 7 publications

(9 citation statements)

References 27 publications

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“…When full alternans appears during stochastic pacing, non‐linear model identification can then be applied to provide further insights into the characteristics of the period‐doubling bifurcation (Armoundas et al . ; Dai & Keener ).…”

Section: Discussionmentioning

confidence: 99%

“…If non‐linearities need to be accounted for, the analysis can be extended with non‐linear terms (Armoundas et al . ; Dai & Keener ). However, this approach would have the disadvantage that more data (longer series of APDs/CLs) would be required to obtain reliable non‐linear model identification.…”

Section: Methodsmentioning

confidence: 99%

“…Hence, for the linear analysis using the ARMA model to remain applicable, the stochastic variations of pacing CL must be kept small enough such that non-linearities remain weak. If non-linearities need to be accounted for, the analysis can be extended with non-linear terms (Armoundas et al 2002;Dai & Keener 2012). However, this approach would have the disadvantage that more data (longer series of APDs/CLs) would be required to obtain reliable non-linear model identification.…”

Section: Analysis Of Apd DI and Cl Series And Markers Of Alternansmentioning

confidence: 99%

“…To deploy the maximal efficiency of ARMA model identification, cardiac CL series should also be fully uncorrelated (which is not the case during sinus rhythm or conventional pacing protocols). When full alternans appears during stochastic pacing, non-linear model identification can then be applied to provide further insights into the characteristics of the period-doubling bifurcation (Armoundas et al 2002;Dai & Keener 2012).…”

Section: Extension Of the Analytical Framework From Cell To Organmentioning

confidence: 99%

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Stochastic pacing reveals the propensity to cardiac action potential alternans and uncovers its underlying dynamics

Prudat

Madhvani

Angelini

et al. 2016

The Journal of Physiology

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Key pointsr Beat-to-beat alternation (alternans) of the cardiac action potential duration is known to precipitate life-threatening arrhythmias and can be driven by the kinetics of voltage-gated membrane currents or by instabilities in intracellular calcium fluxes.r To prevent alternans and associated arrhythmias, suitable markers must be developed to quantify the susceptibility to alternans; previous theoretical studies showed that the eigenvalue of the alternating eigenmode represents an ideal marker of alternans.r Using rabbit ventricular myocytes, we show that this eigenvalue can be estimated in practice by pacing these cells at intervals varying stochastically.r We also show that stochastic pacing permits the estimation of further markers distinguishing between voltage-driven and calcium-driven alternans.r Our study opens the perspective to use stochastic pacing during clinical investigations and in patients with implanted pacing devices to determine the susceptibility to, and the type of alternans, which are both important to guide preventive or therapeutic measures.Abstract Alternans of the cardiac action potential (AP) duration (APD) is a well-known arrhythmogenic mechanism. APD depends on several preceding diastolic intervals (DIs) and APDs, which complicates the prediction of alternans. Previous theoretical studies pinpointed a marker called λ alt that directly quantifies how an alternating perturbation persists over successive APs. When the propensity to alternans increases, λ alt decreases from 0 to -1. Our aim was to quantify λ alt experimentally using stochastic pacing and to examine whether stochastic pacing allows discriminating between voltage-driven and Ca 2+ -driven alternans. APs were recorded in rabbit ventricular myocytes paced at cycle lengths (CLs) decreasing progressively and incorporating stochastic variations. Fitting APD with a function of two previous APDs and CLs permitted us to estimate λ alt along with additional markers characterizing whether the dependence of APD on previous DIs or CLs is strong (typical for voltage-driven alternans) or weak (Ca 2+ -driven alternans). During the recordings, λ alt gradually decreased from around 0 towards -1. Intermittent alternans appeared when λ alt reached -0.8 and was followed by sustained alternans. The additional markers detected that alternans was Ca 2+ driven in control experiments and voltage driven in the presence of ryanodine. This distinction could be made even before alternans was manifest (specificity/sensitivity >80% for -0.4 > λ alt > -0.5). These observations were confirmed in a mathematical model of a rabbit ventricular myocyte. In conclusion, stochastic pacing allows the practical estimation of λ alt to reveal the onset of alternans and distinguishes between voltage-driven and Ca 2+ -driven mechanisms, which is important since these two mechanisms may precipitate arrhythmias in different manners.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Analysis Of Apd DI and Cl Series And Markers Of Alternansmentioning

confidence: 99%

Section: Extension Of the Analytical Framework From Cell To Organmentioning

confidence: 99%

See 2 more Smart Citations

Stochastic pacing reveals the propensity to cardiac action potential alternans and uncovers its underlying dynamics

Prudat

Madhvani

Angelini

et al. 2016

The Journal of Physiology

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“…Now, we intent to investigate one of the dramatic nonlinear effects, known as the nonlinear tunneling (NL). Recently, many leading research works have been devoted to investigate the tunneling of solitons in different physical systems [49][50][51][53][54][55][56][57][58][59][60][61]. All pioneering works have shown that the soliton can pass through the barrier without loss under a special conditions, which depends on the ratio between the height of the barrier and the amplitude of the soliton.…”

Section: Nonlinear Tunneling Effectmentioning

confidence: 99%

Ultrashort dark solitons interactions and nonlinear tunneling in the modified nonlinear Schrödinger equation with variable coefficient

Musammil

Porsezian

Nithyanandan

et al. 2017

Optical Fiber Technology

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Stochastic Cardiac Pacing Increases Ventricular Electrical Stability—A Computational Study

Dvir

Zlochiver

2013

Biophysical Journal

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The ventricular tissue is activated in a stochastic rather than in a deterministic rhythm due to the inherent heart rate variability (HRV). Low HRV is a known predictor for arrhythmia events and traditionally is attributed to autonomic nervous system tone damage. Yet, there is no model that directly assesses the antiarrhythmic effect of pacing stochasticity per se. One-dimensional (1D) and two-dimensional (2D) human ventricular tissues were modeled, and both deterministic and stochastic pacing protocols were applied. Action potential duration restitution (APDR) and conduction velocity restitution (CVR) curves were generated and analyzed, and the propensity and characteristics of action potential duration (APD) alternans were investigated. In the 1D model, pacing stochasticity was found to sustain a moderating effect on the APDR curve by reducing its slope, rendering the tissue less arrhythmogenic. Moreover, stochasticity was found to be a significant antagonist to the development of concordant APD alternans. These effects were generally amplified with increased variability in the pacing cycle intervals. In addition, in the 2D tissue configuration, stochastic pacing exerted a protective antiarrhythmic effect by reducing the spatial APD heterogeneity and converting discordant APD alternans to concordant ones. These results suggest that high cardiac pacing stochasticity is likely to reduce the risk of cardiac arrhythmias in patients.

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Using noise to determine cardiac restitution with memory

Cited by 7 publications

References 27 publications

Stochastic pacing reveals the propensity to cardiac action potential alternans and uncovers its underlying dynamics

Stochastic pacing reveals the propensity to cardiac action potential alternans and uncovers its underlying dynamics

Ultrashort dark solitons interactions and nonlinear tunneling in the modified nonlinear Schrödinger equation with variable coefficient

Stochastic Cardiac Pacing Increases Ventricular Electrical Stability—A Computational Study

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