Role of structural barriers in the mechanism of alternans-induced reentry

Circulation Research
Joseph M Pastore, David S Rosenbaum


Previously, using an animal model of T-wave alternans in structurally normal myocardium, we demonstrated that repolarization can alternate with opposite phase between neighboring myocytes (ie, discordant alternans), causing spatial dispersions of repolarization that form the substrate for functional block and reentrant ventricular fibrillation (VF). However, the mechanisms responsible for cellular discordant alternans and its electrocardiographic manifestation (ie, T-wave alternans) in patients with structural heart disease are unknown. We hypothesize that electrotonic uncoupling between neighboring regions of cells by a structural barrier (SB) is a mechanism for discordant alternans. Using voltage-sensitive dyes, ventricular action potentials were recorded from 26 Langendorff-perfused guinea pig hearts in the absence (ie, control) and presence of an insulating SB produced by an epicardial laser lesion. Quantitative analysis of magnitude and phase of cellular alternans revealed that in controls, action potential duration alternated in phase at all ventricular sites above a critical heart rate (269+/-17 bpm), ie, concordant alternans. Also, above a faster critical heart rate threshold (335+/-24 bpm), action potential duration al...Continue Reading


Jul 12, 2008·Annals of Biomedical Engineering·Laura BurattiniRoberto Burattini
Aug 15, 2003·Current Cardiology Reports·Etienne J Pruvot, David S Rosenbaum
Jan 15, 2009·Current Treatment Options in Cardiovascular Medicine·Vikas Kuriachan, Derek V Exner
Jan 13, 2004·Journal of Electrocardiology·Quan PhamDavid S Rosenbaum
Jul 11, 2002·Journal of the American College of Cardiology·Antonis A ArmoundasHans D Esperer
Jul 25, 2003·Pacing and Clinical Electrophysiology : PACE·Jan NemecWin-Kuang Shen
Feb 6, 2010·Médecine sciences : M/S·Philippe ComtoisAlain Vinet
Jul 27, 2005·IEEE Transactions on Bio-medical Engineering·Anil MaybhateDavid J Christini
Dec 2, 2009·Circulation. Arrhythmia and Electrophysiology·Michael J CutlerDavid S Rosenbaum
Mar 25, 2011·Circulation. Arrhythmia and Electrophysiology·Eric H WeissAntonis A Armoundas
Jan 8, 2011·Circulation Research·James N WeissZhilin Qu
Oct 26, 2005·Circulation Journal : Official Journal of the Japanese Circulation Society·Kenji HiromotoMitsumasa Ohyanagi
Nov 29, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Jin Won KimYoung-Hoon Kim
May 15, 2010·Circulation Journal : Official Journal of the Japanese Circulation Society·Valentina Otja PuntmannJohn Camm
Dec 3, 2009·International Heart Journal·Shin MatsumotoKyoichi Mizuno
Jun 5, 2003·Chaos·David J Christini, Leon Glass
Feb 25, 2014·The International Journal of Cardiovascular Imaging·Karin KraaierMarcoen F Scholten
Jul 25, 2013·Current Cardiology Reports·Faisal M MerchantAntonis A Armoundas
Jan 2, 2003·The Journal of Physiology·Lothar A BlatterStephen L Lipsius
Jan 1, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Antonis A ArmoundasFaisal M Merchant
Oct 19, 2011·Translational Research : the Journal of Laboratory and Clinical Medicine·Michael A KwofieJames B Martins
May 3, 2011·Journal of Theoretical Biology·Mathieu LemayJan P Kucera
May 12, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·David J Christini
Dec 2, 2014·Journal of Theoretical Biology·Ning WeiElena G Tolkacheva
Jul 28, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·David J Christini
Mar 11, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Navinder Sawhney, Sanjiv M Narayan
Jan 27, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michael J Cutler, David S Rosenbaum
Feb 4, 2009·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Lance D WilsonDavid S Rosenbaum
May 27, 2008·Journal of Molecular and Cellular Cardiology·Rachel C MylesGodfrey L Smith
Jul 5, 2008·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Roopinder K SandhuKara J Quan
Dec 7, 2007·Journal of Molecular and Cellular Cardiology·Kenneth R Laurita, David S Rosenbaum
Nov 13, 2007·Journal of Electrocardiology·Alan Garfinkel
Aug 10, 2005·Seminars in Thoracic and Cardiovascular Surgery·Michael M H CheungAndrew N Redington


Jan 23, 1992·The New England Journal of Medicine·R S Liblau, L Fugger
Oct 1, 1984·The American Journal of Cardiology·Z ShimoniD Kohn
Jan 27, 1994·The New England Journal of Medicine·David S RosenbaumR J Cohen
Nov 1, 1996·Journal of Cardiovascular Electrophysiology·S D GirouardDavid S Rosenbaum
Aug 1, 1997·Journal of the American College of Cardiology·P H PakD A Kass
Sep 23, 1997·Journal of Cardiovascular Electrophysiology·S H HohnloserR J Cohen
May 15, 1998·IEEE Transactions on Bio-medical Engineering·P V BaylyW M Smith
Jul 31, 1998·Journal of Cardiovascular Electrophysiology·N G KaveshM R Gold

Related Concepts

Ventricular Fibrillation
Congenital Structural Myopathy
Muscle Cells
Action Potentials
Ventricular Tachycardia, Monomorphic
Transcription Initiation

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