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Modelling far field pacing for terminating spiral waves pinned to ischaemic heterogeneities in cardiac tissue

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Boccia,  Edda
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Luther,  Stefan
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Parlitz,  Ulrich
Research Group Biomedical Physics, Max Planck Institute for Dynamics and Self-Organization, Max Planck Society;

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Citation

Boccia, E., Luther, S., & Parlitz, U. (2017). Modelling far field pacing for terminating spiral waves pinned to ischaemic heterogeneities in cardiac tissue. Philosophical Transactions of the Royal Society A: Mathematical, Physical and Engineering Sciences, 375(2102): 20160289. doi:10.1098/rsta.2016.0289.


Cite as: http://hdl.handle.net/11858/00-001M-0000-002D-C955-5
Abstract
In cardiac tissue, electrical spiral waves pinned to a heterogeneity can be unpinned (and eventually terminated) using electric far field pulses and recruiting the heterogeneity as a virtual electrode. While for isotropic media the process of unpinning is much better understood, the case of an anisotropic substrate with different conductivities in different directions still needs intensive investigation. To study the impact of anisotropy on the unpinning process, we present numerical simulations based on the bidomain formulation of the phase I of the Luo and Rudy action potential model modified due to the occurrence of acute myocardial ischaemia. Simulating a rotating spiral wave pinned to an ischaemic heterogeneity, we compare the success of sequences of far field pulses in the isotropic and the anisotropic case for spirals still in transient or in steady rotation states. Our results clearly indicate that the range of pacing parameters resulting in successful termination of pinned spiral waves is larger in anisotropic tissue than in an isotropic medium. This article is part of the themed issue ‘Mathematical methods in medicine: neuroscience, cardiology and pathology’.