Period of Arrhythmia Anchored around an Infarction Scar in an Anatomical Model of the Human Ventricles

Abstract

Rotating nonlinear waves of excitation in the heart cause dangerous cardiac arrhythmias. Frequently, ventricular arrhythmias occur as a result of myocardial infarction and are associated with rotation of the waves around a post-infarction scar. In this paper, we perform a detailed in silico analysis of scroll waves in an anatomical model of the human ventricles with a generic model of the infarction scar surrounded by the gray zone with modified properties of the myocardial tissue. Our model includes a realistic description of the heart shape, anisotropy of cardiac tissue and a detailed description of the electrical activity in human ventricular cells by a TP06 ionic model. We vary the size of the scar and gray zone and analyze the dependence of the rotation period on the injury dimensions. Two main regimes of wave scrolling are observed: the scar rotation, when the wave rotates around the scar, and the gray zone rotation, when the wave rotates around the boundary of the gray zone and normal tissue. The transition from the gray zone to the scar rotation occurs for the width of gray zone above 10–20 mm, depending on the perimeter of the scar. We compare our results with simulations in 2D and show that 3D anisotropy reduces the period of rotation. We finally use a model with a realistic shape of the scar and show that our approach predicts correctly the period of the arrhythmia.