Basis for the Induction of Tissue-Level Phase-2 Reentry as a Repolarization Disorder in the Brugada Syndrome

Joint Authors

Bueno-Orovio, Alfonso
Cherry, Elizabeth M.
Evans, Steven J.
Fenton, Flavio H.

Source

BioMed Research International

Issue

Vol. 2015, Issue 2015 (31 Dec. 2015), pp.1-12, 12 p.

Publisher

Hindawi Publishing Corporation

Publication Date

2015-10-25

Country of Publication

Egypt

No. of Pages

12

Main Subjects

Medicine

Abstract EN

Aims.

Human action potentials in the Brugada syndrome have been characterized by delayed or even complete loss of dome formation, especially in the right ventricular epicardial layers.

Such a repolarization pattern is believed to trigger phase-2 reentry (P2R); however, little is known about the conditions necessary for its initiation.

This study aims to determine the specific mechanisms that facilitate P2R induction in Brugada-affected cardiac tissue in humans.

Methods.

Ionic models for Brugada syndrome in human epicardial cells were developed and used to study the induction of P2R in cables, sheets, and a three-dimensional model of the right ventricular free wall.

Results.

In one-dimensional cables, P2R can be induced by adjoining lost-dome and delayed-dome regions, as mediated by tissue excitability and transmembrane voltage profiles, and reduced coupling facilitates its induction.

In two and three dimensions, sustained reentry can arise when three regions (delayed-dome, lost-dome, and normal epicardium) are present.

Conclusions.

Not only does P2R induction by Brugada syndrome require regions of action potential with delayed-dome and lost-dome, but in order to generate a sustained reentry from a triggered waveback multiple factors are necessary, including heterogeneity in action potential distribution, tissue coupling, direction of stimulation, the shape of the late plateau, the duration of lost-dome action potentials, and recovery of tissue excitability, which is predominantly modulated by tissue coupling.

American Psychological Association (APA)

Bueno-Orovio, Alfonso& Cherry, Elizabeth M.& Evans, Steven J.& Fenton, Flavio H.. 2015. Basis for the Induction of Tissue-Level Phase-2 Reentry as a Repolarization Disorder in the Brugada Syndrome. BioMed Research International،Vol. 2015, no. 2015, pp.1-12.
https://search.emarefa.net/detail/BIM-1054599

Modern Language Association (MLA)

Bueno-Orovio, Alfonso…[et al.]. Basis for the Induction of Tissue-Level Phase-2 Reentry as a Repolarization Disorder in the Brugada Syndrome. BioMed Research International No. 2015 (2015), pp.1-12.
https://search.emarefa.net/detail/BIM-1054599

American Medical Association (AMA)

Bueno-Orovio, Alfonso& Cherry, Elizabeth M.& Evans, Steven J.& Fenton, Flavio H.. Basis for the Induction of Tissue-Level Phase-2 Reentry as a Repolarization Disorder in the Brugada Syndrome. BioMed Research International. 2015. Vol. 2015, no. 2015, pp.1-12.
https://search.emarefa.net/detail/BIM-1054599

Data Type

Journal Articles

Language

English

Notes

Includes bibliographical references

Record ID

BIM-1054599