Abstract

HENAO, Óscar A; FERRERO DE LOMA-OSORIO, José M; SAIZ, Javier  and  REYNOLDS, Jorge. Arrhythmias potentiated by sub-epicardial ischemia in transmural heterogeneous cardiac wall: theoretical simulation study. Rev. Colom. Cardiol. [online]. 2011, vol.18, n.1, pp.37-51. ISSN 0120-5633.

Ventricular fibrillation, myocardial ischemia and sudden cardiac death are inseparable cardiac pathophysiologies. The influence of the distribution of myocardial cells in the formation of arrhythmias in the heterogeneous cardiac wall in the presence of sub-epicardial ischemia is not entirely elucidated. This study models a flat portion of the transmural wall under different myocardial cell configurations attached to the biochemical heterogeneity present in sub-epicardial ischemia to quantify their influence on the development of arrhythmias. Lobular non-sustained reentries were obtained around the ischemic lesion that interfere with M cells, altering the tissue repolarization. Vulnerability function that quantifies prospection to reentries is approximated by a logistic function, and its main expression occurs in 8.75 minutes of modeled ischemia. The biochemical and morphological heterogeneity in the virtual tissue studied results in a reentrant arrhythmia; its sequel to the tissue vulnerability increases as the severity of hyperkalemia grows. Electrograms obtained show TQ depression and ST elevation with a morphology of polymorphic ventricular tachycardia.

Keywords : M cells; electrograms; vulnerability function; sub-epicardial ischemia; Luo-Rudy model.

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