Department of Physiology, University of Bern, Bern, Switzerland.
Biophys J. 2009 Jan;96(1):294-311. doi: 10.1016/j.bpj.2008.09.025.
The restitution properties of cardiac action potential duration (APD) and conduction velocity (CV) are important factors in arrhythmogenesis. They determine alternans, wavebreak, and the patterns of reentrant arrhythmias. We developed a novel approach to characterize restitution using transfer functions. Transfer functions relate an input and an output quantity in terms of gain and phase shift in the complex frequency domain. We derived an analytical expression for the transfer function of interbeat intervals (IBIs) during conduction from one site (input) to another site downstream (output). Transfer functions can be efficiently obtained using a stochastic pacing protocol. Using simulations of conduction and extracellular mapping of strands of neonatal rat ventricular myocytes, we show that transfer functions permit the quantification of APD and CV restitution slopes when it is difficult to measure APD directly. We find that the normally positive CV restitution slope attenuates IBI variations. In contrast, a negative CV restitution slope (induced by decreasing extracellular [K(+)]) amplifies IBI variations with a maximum at the frequency of alternans. Hence, it potentiates alternans and renders conduction unstable, even in the absence of APD restitution. Thus, stochastic pacing and transfer function analysis represent a powerful strategy to evaluate restitution and the stability of conduction.
心脏动作电位时程 (APD) 和传导速度 (CV) 的恢复特性是心律失常发生的重要因素。它们决定了交替、波破裂和折返性心律失常的模式。我们开发了一种使用传递函数来描述恢复特性的新方法。传递函数根据增益和复频域中的相移来关联输入和输出数量。我们推导出了一个关于从一个部位(输入)到下游另一个部位(输出)传导期间的心动周期间期 (IBI) 的传递函数的解析表达式。传递函数可以使用随机起搏方案有效地获得。使用传导模拟和新生大鼠心室肌细胞的细胞外映射,我们表明,当直接测量 APD 困难时,传递函数可以定量 APD 和 CV 恢复斜率。我们发现,正常的正 CV 恢复斜率会减弱 IBI 变化。相比之下,负 CV 恢复斜率(由细胞外 [K(+)] 减少引起)会放大 IBI 变化,在交替频率处达到最大值。因此,它增强了交替,使传导不稳定,即使在没有 APD 恢复的情况下也是如此。因此,随机起搏和传递函数分析代表了评估恢复和传导稳定性的强大策略。