RESUMO
Cardiac tissues are able to work within a wide range of frequencies to respond to the changing requirements an organism may have. However, during these frequency variations and under certain pathologic conditions arrhythmias such as blocks, tachycardia, fibrillation, etc, may arise some with fatal consequences. For this reason several experimental procedures have been developed that have shown to be useful in studying whole heart properties, or as an alternative from portions of it when changes in its work rate are imposed. This study reports different phenomena occurring in the papillary muscle of the guinea pig heart when stimulated at very high frequency, of several tens of pps, while analyzing its responses during gradual increments starting at 1 (pulses per second). We found that in our conditions papillary muscles display N:1 rhythms with progressive higher N; further more we found that between one and the next rhythm diverse transition patterns appear, among them a new one that we have named "burst pattern". Finally we show that our system exhibits a generalized process of hysteresis by frequency, being this the first report for guinea pig cardiac tissue and the first one to show also the presence of several hysteresis loops in the same experiment. Due to the large volume of generated data we used a faster and easier way to analyze and display them, based on the fast Fourier transform (FFT). The method is briefly described.
Assuntos
Potenciais de Ação/fisiologia , Arritmias Cardíacas/fisiopatologia , Músculos Papilares/fisiologia , Animais , Estimulação Elétrica , Eletrocardiografia , Eletrofisiologia , Cobaias , Masculino , Função VentricularRESUMO
Los tejidos cardíacos son capaces de trabajar en un amplio intervalo de frecuencias con el fin de atender las distintas demandas que el organismo impone al sistema cardiovascular. Sin embargo, bajo un régimen de cambios de frecuencia y con ciertas condiciones patológicas, pueden desarrollarse arritmias, como bloqueos, taquicardias, fibrilaciones, etc. de posibles consecuencias fatales. Esto motiva la realización de diversos arreglos experimentales en los cuales se explora el comportamiento del corazón, o de regiones de éste. En este artículo reportamos diversos fenómenos que ocurren en el músculo papilar de cobayo cuando se le estimula eléctricamente, desde una frecuencia basal de un pulso por segundo (pps) hasta frecuencias muy altas, de varias decenas de pps, pero incrementando paulatinamente la frecuencia de estimulación. Describimos que en nuestras condiciones experimentales, el músculo despliega sucesivamente ritmos tipo n:1 (una respuesta cada n estímulos) con n creciente; encontramos también que entre uno y otro de estos ritmos aparecen diversas formas de transición, entre las cuales describimos una totalmente nueva en este sistema, que hemos denominado por "ráfagas"; finalmente mostramos que este sistema exhibe de manera generalizada histéresis en la frecuencia, siendo el primer reporte que se hace para esta especie y además el primer reporte en el que se muestran varias "asas" o regiones de histéresis por frecuencia dentro de una misma excursión experimental. Debido al gran volumen de datos generados, hemos introducido una forma de presentación y análisis concisa y eficiente, basada en los espectros de potencia de los datos obtenidos a través de la transformada rápida de Fourier. Este método también se describe brevemente en el artículo.
Cardiac tissues are able to work within a wide range of frequencies to respond to the changing requirements an organism may have. However, during these frequency variations and under certain pathologic conditions arrhythmias such as blocks, tachycardia, fibrillation, etc, may arise some with fatal consequences. For this reason several experimental procedures have been developed that have shown to be useful in studying whole heart properties, or as an alternative from portions of it when changes in its work rate are imposed. This study reports different phenomena occurring in the papillary muscle of the guinea pig heart when stimulated at very high frequency, of several tens of pps, while analyzing its responses during gradual increments starting at 1 (pulses per second). We found that in our conditions papillary muscles display N:1 rhythms with progressive higher N; further more we found that between one and the next rhythm diverse transition patterns appear, among them a new one that we have named "burst pattern". Finally we show that our system exhibits a generalized process of hysteresis by frequency, being this the first report for guinea pig cardiac tissue and the first one to show also the presence of several hysteresis loops in the same experiment. Due to the large volume of generated data we used a faster and easier way to analyze and display them, based on the fast Fourier transform (FFT). The method is briefly described. (Arch Cardiol Mex 2004; 74:11-24).
Assuntos
Animais , Cobaias , Masculino , Potenciais de Ação/fisiologia , Arritmias Cardíacas/fisiopatologia , Músculos Papilares/fisiologia , Estimulação Elétrica , Eletrocardiografia , Eletrofisiologia , Função VentricularRESUMO
It has been known for several decades that electrical alternans occurs during myocardial ischemia in both clinical and experimental work. There are a few reports showing that this alternans can be triggered into existence by a premature ventricular contraction. Detriggering of alternans by a premature ventricular contraction, as well as pause-induced triggering and detriggering, have also been reported. We conduct a search for triggered alternans in an ionic model of ischemic ventricular muscle in which alternans has been described recently: a one-dimensional cable of length 3 cm, containing a central ischemic zone 1 cm long, with 1 cm segments of normal (i.e., nonischemic) tissue at each end. We use a modified form of the Luo-Rudy [Circ. Res. 68, 1501-1526 (1991)] ionic model to represent the ventricular tissue, modeling the effect of ischemia by raising the external potassium ion concentration ([K(+)](o)) in the central ischemic zone. As [K(+)](o) is increased at a fixed pacing cycle length of 400 ms, there is first a transition from 1:1 rhythm to alternans or 2:2 rhythm, and then a transition from 2:2 rhythm to 2:1 block. There is a range of [K(+)](o) over which there is coexistence of 1:1 and 2:2 rhythms, so that dropping a stimulus from the periodic drive train during 1:1 rhythm can result in the conversion of 1:1 to 2:2 rhythm. Within the bistable range, the reverse transition from 2:2 to 1:1 rhythm can be produced by injection of a well-timed extrastimulus. Using a stimulation protocol involving delivery of pre- and post-mature stimuli, we derive a one-dimensional map that captures the salient features of the results of the cable simulations, i.e., the {1:1-->2:2-->2:1} transitions with {1:1<-->2:2} bistability. This map uses a new index of the global activity in the cable, the normalized voltage integral. Finally, we put forth a simple piecewise linear map that replicates the {1:1<-->2:2} bistability observed in the cable simulations and in the normalized voltage integral map. (c) 2002 American Institute of Physics.
RESUMO
Life-threatening arrhythmias such as ventricular tachycardia and fibrillation often occur during acute myocardial ischemia. During the first few minutes following coronary occlusion, there is a gradual rise in the extracellular concentration of potassium ions ([K(+)](0)) within ischemic tissue. This elevation of [K(+)](0) is one of the main causes of the electrophysiological changes produced by ischemia, and has been implicated in inducing arrhythmias. We investigate an ionic model of a 3 cmx3 cm sheet of normal ventricular myocardium containing an ischemic zone, simulated by elevating [K(+)](0) within a centrally-placed 1 cmx1 cm area of the sheet. As [K(+)](0) is gradually raised within the ischemic zone from the normal value of 5.4 mM, conduction first slows within the ischemic zone and then, at higher [K(+)](0), an arc of block develops within that area. The area distal to the arc of block is activated in a delayed fashion by a retrogradely moving wavefront originating from the distal edge of the ischemic zone. With a further increase in [K(+)](0), the point eventually comes where a very small increase in [K(+)](0) (0.01 mM) results in the abrupt transition from a global period-1 rhythm to a global period-2 rhythm in the sheet. In the peripheral part of the ischemic zone and in the normal area surrounding it, there is an alternation of action potential duration, producing a 2:2 response. Within the core of the ischemic zone, there is an alternation between an action potential and a maintained small-amplitude response ( approximately 30 mV in height). With a further increase of [K(+)](0), the maintained small-amplitude response turns into a decrementing subthreshold response, so that there is 2:1 block in the central part of the ischemic zone. A still further increase of [K(+)](0) leads to a transition in the sheet from a global period-2 to a period-4 rhythm, and then to period-6 and period-8 rhythms, and finally to a complete block of propagation within the ischemic core. When the size of the sheet is increased to 4 cmx4 cm (with a 2 cmx2 cm ischemic area), one observes essentially the same sequence of rhythms, except that the period-6 rhythm is not seen. Very similar sequences of rhythms are seen as [K(+)](0) is increased in the central region (1 or 2 cm long) of a thin strand of tissue (3 or 4 cm long) in which propagation is essentially one-dimensional and in which retrograde propagation does not occur. While reentrant rhythms resembling tachycardia and fibrillation were not encountered in the above simulations, well-known precursors to such rhythms (e.g., delayed activation, arcs of block, two-component upstrokes, retrograde activation, nascent spiral tips, alternans) were seen. We outline how additional modifications to the ischemic model might result in the emergence of reentrant rhythms following alternans. (c) 2000 American Institute of Physics.