Rotational Activity Around an Obstacle in 2D Cardiac Tissue in Presence of Cellular Heterogeneity

Abstract

Waves of electrical excitation rotating around an obstacle is one of the important mechanisms of dangerous cardiac arrhythmias occurring in the heart damaged by post-infarction scar. Such a scar also has a border zone around it, which has electrophysiological properties different from the rest of normal myocardial tissue. Spatial patterns of wave rotation in the presence of such tissue heterogeneity are poorly studied. In this paper we perform a comprehensive numerical study of various regimes of rotation of a wave in a plane layer of the ventricular tissue around an obstacle surrounded by a gray zone. We use a TP06 cellular ionic model which reproduces the electrophysiological properties of cardiomyocytes in the left ventricle of human heart. We vary the extent of obstacle and gray zone and study the pattern of wave rotation and its period. We observed different regimes of wave rotation that can be subdivided into several classes: (1) functional rotation and (2) scar rotation regimes, which were identified in the previous studies, and new (3) gray zone rotation regime: where the wave instead of rotation around the obstacle, rotates around the gray zone (an area of tissue heterogeneity) itself. For each class, the period of rotation is determined by different factors, which we discuss and quantify. We also found that due to regional pathological remodeling of myocardial tissue, we can obtain additional regimes associated with dynamical instabilities of two types which may affect or not affect the period of rotation.