Carolyn M. Berger

Cardiac Alternans Arising From an Unfolded Border-Collision Bifurcation

Following an electrical stimulus, the transmembrane voltage of cardiac tissue rises rapidly and remains at a constant value before returning to the resting value, a phenomenon known as an action potential. When the pacing rate of a periodic train of stimuli is increased above a critical value, the action potential undergoes a period-doubling bifurcation, where the resulting alternation of the action potential duration is known as alternans in medical literature. Existing cardiac models treat alternans either as a smooth or as a border-collision bifurcation. However, recent experiments in paced cardiac tissue reveal that the bifurcation to alternans exhibits hybrid smooth/nonsmooth behaviors, which can be qualitatively described by a model of so-called unfolded border-collision bifurcation. In this paper, we obtain analytical solutions of the unfolded border-collision model and use it to explore the crossover between smooth and nonsmooth behaviors. Our analysis shows that the hybrid smooth/nonsmooth behavior is due to large variations in the systems properties over a small interval of the bifurcation parameter, providing guidance for the development of future models.

Spatial heterogeneity of restitution properties and the onset of alternans

Traditionally, it was believed that cardiac rhythm stability was governed by the slope of the restitution curve (RC), which relates the duration of an action potential to the preceding diastolic interval. However, a single RC does not exist; rate-dependence leads to multiple distinct RCs. We measure spatial differences in the steady-state action potential duration (APD), as well as in three different RCs: the S1-S2 (SRC), constant-basic-cycle-length (BRC), and dynamic (DRC), and correlate these differences with the tissue’s propensity to develop alternans. The results show that spatial differences in APD, SRC slope, and DRC slope are correlated with the tissue’s propensity to exhibit alternans. These results may lead to a new diagnostic approach to identifying patients with vulnerability to arrhythmias, which will involve pacing at slow rates and analyzing spatial differences in restitution properties.