Perspective: a dynamics-based classification of ventricular arrhythmias

Journal of Molecular and Cellular Cardiology
James N WeissZhilin Qu

Abstract

Despite key advances in the clinical management of life-threatening ventricular arrhythmias, culminating with the development of implantable cardioverter-defibrillators and catheter ablation techniques, pharmacologic/biologic therapeutics have lagged behind. The fundamental issue is that biological targets are molecular factors. Diseases, however, represent emergent properties at the scale of the organism that result from dynamic interactions between multiple constantly changing molecular factors. For a pharmacologic/biologic therapy to be effective, it must target the dynamic processes that underlie the disease. Here we propose a classification of ventricular arrhythmias that is based on our current understanding of the dynamics occurring at the subcellular, cellular, tissue and organism scales, which cause arrhythmias by simultaneously generating arrhythmia triggers and exacerbating tissue vulnerability. The goal is to create a framework that systematically links these key dynamic factors together with fixed factors (structural and electrophysiological heterogeneity) synergistically promoting electrical dispersion and increased arrhythmia risk to molecular factors that can serve as biological targets. We classify ventricular ...Continue Reading

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Citations

Jan 2, 2016·Progress in Biophysics and Molecular Biology·Michael ClerxPaul G A Volders
Apr 20, 2016·Journal of Arrhythmia·Gary Tse
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Feb 23, 2019·Frontiers in Pharmacology·Taiyi WangYu-Ling Ma
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Apr 11, 2019··Hortensia G. González GómezMaría Luisa Durán-Pastén

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