Cardiac dynamics: Alternans and arrhythmogenesis
| Autor: | Vivian Tse, Hiu Yu Lin, Jie Ming Yeo, Sheung Ting Wong, Yee Ting Lee, Gary Tse |
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| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system Exacerbation Calcium handling Refractory period Review 030204 cardiovascular system & hematology Cardiac repolarization Cardiac arrhythmia 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Repolarization Restitution business.industry Dynamics 030104 developmental biology lcsh:RC666-701 Re-entry Time course Cardiology Cardiology and Cardiovascular Medicine business Alternans |
| Zdroj: | Journal of Arrhythmia Journal of Arrhythmia, Vol 32, Iss 5, Pp 411-417 (2016) |
| ISSN: | 1880-4276 |
| Popis: | Pre-existing heterogeneities present in cardiac tissue are essential for maintaining the normal electrical and mechanical functions of the heart. Exacerbation of such heterogeneities or the emergence of dynamic factors can produce repolarization alternans, which are beat-to-beat alternations in the action potential time course. Traditionally, this was explained by restitution, but additional factors, such as cardiac memory, calcium handling dynamics, refractory period restitution, and mechano-electric feedback, are increasingly recognized as the underlying causes. The aim of this article is to review the mechanisms that generate cardiac repolarization alternans and convert spatially concordant alternans to the more arrhythmogenic spatially discordant alternans. This is followed by a discussion on how alternans generate arrhythmias in a number of clinical scenarios, and concluded by an outline of future therapeutic targets for anti-arrhythmic therapy. |
| Databáze: | OpenAIRE |
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