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Biomedical subjects

A Vinet

Publications and source records attributed to A Vinet.

At least 19 recordsLinked to original sources

Development and implementation of a participative intervention to improve the psychosocial work environment and mental health in an acute care hospital.

OBJECTIVES: To describe the development and implementation phases of a participative intervention aimed at reducing four theory grounded and empirically supported adverse psychosocial work factors (high psychological demands, low decision latitude, low social support, and low reward), and their mental health effects. METHODS: The intervention was realised among 500 care providers in an acute care hospital. A prior risk evaluation was performed, using a quantitative approach, to determine the prevalence of adverse psychosocial work factors and of psychological distress in the hospital compared to an appropriate reference population. In addition, a qualitative approach included observation in the care units, interviews with key informants, and collaborative work with an intervention team (IT) including all stakeholders. RESULTS: The prior risk evaluation showed a high prevalence of adverse psychosocial factors and psychological distress among care providers compared to a representative sample of workers from the general population. Psychosocial variables at work associated with psychological distress in the prior risk evaluation were high psychological demands (prevalence ratio (PR) = 2.27), low social support from supervisors and co-workers (PR = 1.35), low reward (PR = 2.92), and effort-reward imbalance (PR = 2.65). These results showed the empirical relevance of an intervention on the four selected adverse psychosocial factors among care providers. Qualitative methods permitted the identification of 56 adverse conditions and of their solutions. Targets of intervention were related to team work and team spirit, staffing processes, work organisation, training, communication, and ergonomy. CONCLUSION: This study adds to the scarce literature describing the development and implementation of preventive intervention aimed at reducing psychosocial factors at work and their health effects. Even if adverse conditions in the psychosocial environment and solutions identified in this study may be specific to the healthcare sector, the intervention process used (participative problem solving) appears highly exportable to other work organisations.

Adaptation, Psychological↗

Effectiveness of a participative intervention on psychosocial work factors to prevent mental health problems in a hospital setting.

OBJECTIVES: To assess the effectiveness of a workplace intervention aimed at reducing adverse psychosocial work factors (psychological demands, decision latitude, social support, and effort-reward imbalance) and mental health problems among care providers. METHODS: A quasi-experimental design with a control group was used. Pre-intervention (71% response rate), and one-year post-intervention measures (69% response rate) were collected by telephone interviews. RESULTS: One year after the intervention, there was a reduction of several adverse psychosocial factors in the experimental group, whereas no such reduction was found in the control group. However, there was a significant deterioration of decision latitude and social support from supervisors in both experimental and control groups. There was also a significant reduction in sleeping problems and work related burnout in the experimental hospital, whereas only sleeping problems decreased in the control group while both client related and personal burnout increased in this hospital. The comparison between the experimental and control groups, after adjusting for pre-intervention measures, showed a significant difference in the means of all psychosocial factors except decision latitude. All other factors were better in the experimental group. CONCLUSION: Results suggest positive effects of the intervention, even though only 12 months have passed since the beginning of the intervention. Follow up at 36 months is necessary to evaluate whether observed effects are maintained over time. In light of these results, we believe that continuing the participative process in the experimental hospital will foster the achievement of a more important reduction of adverse psychosocial factors at work. It is expected that the intensity of the intervention will be directly related to its beneficial effects. Long term effects will however depend on the willingness of management and of staff to appropriate the process of identifying what contributes to adverse psychosocial factors at work and to adopt means to reduce them.

Adolescent↗

Reproducibility of automated pulse wave velocity measurement during exercise. Running head: pulse wave velocity during exercise.

Pulse wave velocity measurement is used as an index of arterial stiffness. The purpose was to evaluate the reproducibility of pulse wave velocity measurement at rest, during exercise and recovery from exercise, using an automated device. Twelve healthy young adults (mean age 22.0 +/- 3.1 yrs) underwent an upright submaximal cycle test on two separate occasions, one week apart. Pulse wave velocity, systolic and diastolic blood pressures and heart rate were assessed at rest, during the last 2 min of exercise and 10 min later. Pulse wave velocity was measured on the upper limb and the forearm by the cross-correlation function of photoplethysmography and Doppler signals. Brachial artery pulse wave velocity was calculated from upper limb and forearm pulse wave velocities. No significant difference was found on duplicate measurements of heart rate, systolic and diastolic blood pressures at rest, during exercise and recovery, showing that pulse wave velocity was measured under similar conditions. Coefficient of variation for upper limb and forearm pulse wave velocities ranged from 2.9 to 5.9% at rest and during recovery, and were respectively 2.9% and 8.3% during exercise. However, coefficient of variation for brachial pulse wave velocity was 7.7 and 10.3% at rest, 15.7% during exercise, and 5.8% during recovery. During exercise, pulse wave velocity measurements were satisfying, but indirect assessment of brachial artery pulse wave velocity showed poor reproducibility. Thus, upper limb and forearm pulse wave velocities may be used during exercise to assess the effect of training or drugs on arterial wall mechanical properties.

Adult↗

Relationships between left ventricular morphology, diastolic function and oxygen carrying capacity and maximal oxygen uptake in children.

Little attention has been paid to children with respect to factors controlling maximal oxygen uptake (V.O (2max)). This study was therefore specifically designed to examine the potential relationships between cardiac size, diastolic function and O (2) carrying capacity with maximal aerobic capacity. Specifically, body size indices (body surface area, lean body mass), resting left ventricular dimensions and filling characteristics, blood haemoglobin concentration as well as V.O (2max) established during a maximal cycle exercise test were assessed in a large cohort (n = 142) of healthy 10 - 11 year old boys and girls. Results were compared between groups of low (< 50, L), moderate (50 - 60, M) and high (> 60, H) V.O (2max) (ml . min (-1) . kg (-1) of lean body mass). Moreover, potential contributors to V.O (2max) variance were investigated using univariate and multivariate regression analyses over the overall population. The major results show no differences between the 3 groups for all diastolic and systolic function indices as well as blood haemoglobin and systemic vascular resistances (used as an index of afterload). None of these variables emerged from regression analyses as potential predictors of V.O (2max.) After accounting for body size variation, heart dimensions, and especially left ventricular internal dimensions, differed between H and M and L and were associated with higher cardiac filling and subsequently stroke volume. Strong relationships between V.O (2max) and heart dimensions were noticed, due primarily but not exclusively to the influence of body size. After adjusting for lean body mass, end-diastolic diameter contributed modestly (8 %) but significantly to V.O (2max) variance, which is biologically meaningful.

Anthropometry↗

Effect of intensive training on heart rate variability in prepubertal swimmers.

BACKGROUND: In children, there is very limited evidence focusing on the beneficial effect of exercise training on heart rate variability (HRV) during childhood. Despite the fact that more and more children are engaged in intensive training programs, the question arises if such intensive training involves deleterious effects on the cardiac autonomic nervous system during childhood. Thus the aim of the present study was to compare HRV parameters in highly trained swimmer boys and untrained counterparts. METHODS: Twenty prepubertal boys, aged 11-12 years old, took part in the study. The children were divided into 11 highly trained prepubertal swimmers (training sessions of 8-10 h weekly for at least 4 years) and 9 age-matched active boys. HRV analysis was performed on diurnal recordings in the frequency (short-term recordings 6 min the most 'vagal') and time (long-term recordings 4 h centred on the 6 min most 'vagal') domains. RESULTS: No significant differences were obtained between groups for all frequency variables whatever the mode of expression (absolute in ms2, relative in Ln or %). All time-domain components were not significantly different in swimmers and untrained boys. CONCLUSIONS: The results of the present study demonstrate that participating intensively in swimming training does not induce in children changes in HRV indices. Neither time nor domain HRV variables were significantly different between untrained and highly trained prepubertal boys. Thus, intensive training in healthy children does not involve deleterious effects on HRV.

Child↗

Use of structured antedependence models for the genetic analysis of growth curves.

Growth curve analysis is an important issue for many agricultural and laboratory species, for both phenotypic and genetic studies. The aim of this paper is to present the use of a novel statistical approach, namely the structured antedependence (SAD) models, to deal with this issue. The basic idea of these models is that an observation at time t can be explained by the previous observations. These models are especially appropriate to deal with cumulative traits such as growth, as BW at age t clearly depends on BW measures at ages (t -1), (t -2), etc. These models were applied on an INRA experimental Charolais herd data set. The data comprised BW records for 560 cows born over an 11-yr period (from 1988 to 1998) from 60 sires and 369 dams. The proposed SAD models were compared with the well-known random regression (RR) models that are already widely used in various areas of longitudinal data analysis. It was found that the SAD models fit the growth process better with far fewer parameters than the RR models (9 instead of 16 covariance parameters for the phenotypic analysis, and 14 instead of 21 for the genetic analysis). Despite this smaller number of covariance parameters, the likelihood value was found to be much higher with the SAD vs. the RR models, with a difference of 262.9 for the phenotypic analysis with a quartic polynomial for the RR and 751.5 for the genetic analysis with a cubic polynomial for both the genetic and environmental parts of the RR model. The SAD models also proved to be better able to interpolate missing values. Heritability, genetic, and environmental correlation coefficients were estimated for weights from birth to adulthood. The structured antedependence models proved, in this study, to be very appropriate to model growth data in a parsimonious and flexible way.

Aging↗

Synchronization and symmetry-breaking bifurcations in constructive networks of coupled chaotic oscillators.

The spatiotemporal dynamics of networks based on a ring of coupled oscillators with regular shortcuts beyond the nearest-neighbor couplings is studied by using master stability equations and numerical simulations. The generic criterion for dynamic synchronization has been extended to arbitrary network topologies with zero row-sum. The symmetry-breaking oscillation patterns that resulted from the Hopf bifurcation from synchronous states are analyzed by the symmetry group theory.

Journal Article↗

Cardiovascular responses to endurance training in children: effect of gender.

BACKGROUND: The aim of the present study was to determine in healthy children the effect of a well-controlled endurance training programme on cardiac function at maximal exercise and to define whether gender affects the training-induced cardiovascular response. The contribution of factors potentially involved in those adaptations such as cardiac dimensions and diastolic and systolic function was also investigated. METHODS: Thirty-five l0-11-year-old children took part in this study: 19 children (10 girls and nine boys) were assigned to participate in a 13-week endurance training programme (3 x 1 h week-1, intensity: > 80% HR max), and 16 (seven girls and nine boys) served as a control group. A resting echocardiographic evaluation and a maximal upright cycle test, including measurement of stroke volume (SV), cardiac output (Q) and blood pressure, were performed in all children before and after the study period. RESULTS: The training programme led to a rise in maximal O2 uptake (VO2max), brought about however, only by an increase in SVmax in both genders. Moreover, the boys increased their VO2max to a greater extent than the girls (boys: +15%; girls: +8%) only because of a higher SVmax improvement (boys: +15%; girls: +11%). No alterations were noticed in the SV pattern from rest to maximal exercise, indicating that the increase in SVrest was a key factor in the improvement of SVmax and thus VO2max. Regarding resting echocardiographic data, an increase in the left ventricular end-diastolic diameter, concomitant with an improvement in diastolic function, was observed after training and constituted an essential element in the rise in VO2max after training in these children. Moreover, during maximal exercise, a decrease in systemic vascular resistances, probably indicating peripheral cardiovascular adaptive changes, might also play an important role in the increase in VO2max. CONCLUSION: Whatever gender, aerobic training increases VO2max in children, mediated by an improvement in SVmax only. Similar mechanisms, including loading conditions and cardiac morphology, seem to be involved in both genders in order to explain such an improvement.

Blood Pressure↗

Prediction of VO(2peak) in wheelchair-dependent athletes from the adapted Léger and Boucher test.

PURPOSE: :The purpose of this study was to provide a predictive peak oxygen uptake ([V]O(2) peak) equation in wheelchair-dependent athletes using the Adapted Léger and Boucher test. SUBJECTS AND PROTOCOL: :Fifty-six wheelchair-dependent athletes, 47 males and nine females (30.3+/-4 years), underwent a clinical examination to assess their anthropometric characteristics: height, mass, body mass index (BMI), lean body mass, arm length, and muscular arm volume. They performed a deceleration field test to assess the subject-wheelchair resistance defined as a mechanical variable, and they then performed the Adapted Léger and Boucher test to assess physiological data at maximal exercise ([V]O(2) peak, heart rate max) concomitantly with biomechanical (number of pushes) and performance variables (maximal aerobic velocity Va(max) and maximal distance). The [V]O(2) peak was measured directly using a portable telemetric oxygen analyzer. Subjects were then randomly assigned to an experimental group (n=49) to determine the predictive equation, and a validation group (n=7) to check the external validity of the equation. RESULTS: A stepwise multiple regression with [V]O(2) peak (l min(-1)) as the dependent variable led to the following equation: [V]O(2) peak=0.22 Va(max) - 0.63 log(age)+0.05 BMI 0.25 level+0.52, with r(2)=0.81 and SEE=0.01. Paraplegic subjects with high and low lesion level spinal injuries were attributed the coefficient of 1 and 0, respectively. The external validity of the equation was positive since the predicted [V]O(2) peak values did not significantly differ from directly measured [V]O(2) peak (P>0.05). CONCLUSION: We concluded that [V]O(2) peak in wheelchair-dependent athletes was predictable using the equation of the present study and the described incremental test.

Adolescent↗

Central and peripheral cardiovascular adaptations to exercise in endurance-trained children.

Stroke volume (SV) response to exercise depends on changes in cardiac filling, intrinsic myocardial contractility and left ventricular afterload. The aim of the present study was to identify whether these variables are influenced by endurance training in pre-pubertal children during a maximal cycle test. SV, cardiac output (Doppler echocardiography), left ventricular dimensions (time-movement echocardiography) as well as arterial pressure and systemic vascular resistances were assessed in 10 child cyclists (VO2max: 58.5 +/- 4.4 mL min-1 kg-1) and 13 untrained children (UTC) (VO2max: 45.9 +/- 6.7 mL min-1 kg-1). All variables were measured at the end of the resting period, during the final minute of each workload and during the last minute of the progressive maximal aerobic test. At rest and during exercise, stroke index was significantly higher in the child cyclists than in UTC. However, the SV patterns were strictly similar for both groups. Moreover, the patterns of diastolic and systolic left ventricular dimensions, and the pattern of systemic vascular resistance of the child cyclists mimicked those of the UTC. SV patterns, as well as their underlying mechanisms, were not altered by endurance training in children. This result implied that the higher maximal SV obtained in child cyclists depended on factors influencing resting SV, such as cardiac hypertrophy, augmented myocardium relaxation properties or expanded blood volume.

Adaptation, Physiological↗

Cardiovascular responses to progressive cycle exercise in healthy children and adults.

The aim of this study was to compare resting, relative submaximal (at the same percentage of maximal oxygen uptake) and maximal cardiovascular responses to progressive cycle exercise in pre-pubertal children and young adults with similar aerobic aptitude. Fourteen healthy children (7 girls and 7 boys) with a mean age of 10.8 yr and 16 healthy young adults (8 women and 8 men) with a mean age of 22.4 yr underwent a progressive cycle test until exhaustion with estimation of stroke volume and cardiac output by Doppler echocardiography. Submaximal responses were evaluated at similar exercise intensities (around 40, 60 and 80 % of maximal oxygen uptake). Mean submaximal and maximal oxygen uptake were not significantly different between the children and the adults. As expected, the adults demonstrated larger absolute values of stroke volume and cardiac output at all levels of intensity but when related to body surface area, the differences disappeared. The relationships between cardiac output and oxygen uptake calculated from comparable submaximal intensities were similar (slopes and intercepts) in the children and the adults. According to these results, it seems that the lower cardiovascular responses to exercise in children may be attributed to their smaller heart size.

Adaptation, Physiological↗

Effect of aerobic training and detraining on left ventricular dimensions and diastolic function in prepubertal boys and girls.

PURPOSE: The purpose of this study was to determine the effect of an aerobic training program on the left ventricular (LV) cardiac morphology and function of prepubertal children. METHODS: Twenty-nine 10-11 year old boys and girls (TG) participated in a 13-week running program (3 x 1 h/week, intensity: > 80% HRmax), 26, of the same age, served as a control group (CG). M-mode, 2-dimensional and pulsed-wave Doppler analyses were performed, during resting conditions, before and after the training period (T) as well as, for TG only, after 2 months of detraining (D). RESULTS: LV internal chamber dimension increased (+ 4.6 %, p < 0.01) while wall thicknesses concomitantly decreased (-10.7%, p < 0.05) as a result of T. All cardiac morphological parameters returned to pretraining values after D. Doppler-derived measurements of LV diastolic filling performance were also significantly altered by Tand D. A significant enhancement in the early diastolic passive LV filling with a concomitant reduction in the late diastolic active LV filling were in fact obtained after T. The training-induced bradycardia (-7 beats x min(-1), p < 0.01) was probably responsible for the changes in the late characteristics of the diastolic active filling. All diastolic filling indexes returned to pretraining values after D. Systolic function indexes were not modified after either T or D. No changes were obtained for the overall LV morphological and functional variables after 13 weeks of normal life for CG. CONCLUSION: These findings indicate that cardiac morphological adaptations can occur in prepubertal children after several months of aerobic training. These alterations differ however, in some areas, to those classically reported in adults following endurance training programs where both an increase in LV size and mass exist. Our data likewise demonstrate that endurance training is able to induce favourable LV diastolic filling modifications, directed principally towards an enhancement in the early rapid filling inflow and a corresponding reduction in the atrial contribution to the total diastolic inflow.

Adaptation, Physiological↗

Reproducibility of cardiac output measurements by Doppler echocardiography in prepubertal children and adults.

The aim of this study was to examine reproducibility of stroke volume and cardiac output measurements by Doppler echocardiography during submaximal and maximal exercise in adults and children. Fourteen healthy children (8 girls and 6 boys aged 10.9 +/- 0.9yr) and eleven healthy young adults (1 female and 10 males aged 22.3 +/- 3.8 yr) underwent a progressive maximal upright cycle test until exhaustion with estimation of stroke volume and cardiac output by Doppler echocardiography on two separate occasions (one week apart). Maximal oxygen uptake and maximal heart rate were not significantly different between both tests in the children and adults indicating that similar exhaustive efforts were achieved at each test. No significant differences for mean values of stroke volume and cardiac output were observed at rest in the children and whatever the exercise intensity in the children and adults. No significant differences were observed between values of root mean square (precision and precision of error) in both groups. Thus we demonstrated that stroke volume and cardiac output values obtained by Doppler echocardiography at rest and during submaximal and maximal exercise were reproducible on test-retest measurements in children and adults.

Adolescent↗

Effect of a 13-week aerobic training programme on the maximal power developed during a force-velocity test in prepubertal boys and girls.

The present study was undertaken in order to evaluate the effect of an aerobic training programme on the maximal power (Pmax) developed during a short-term exercise test in prepubertal children. Thirty-three 10-11 year old boys and girls were investigated: 17 (TG) participated twice a week (1 h per session) in a 13-week running programme and 16 (CG) served as a control group. Pmax was measured during a force-velocity test conducted on a friction-loaded cycle ergometer. The force (Fopt) and velocity (Vopt) at which Pmax was obtained were determined. Lower limb muscle mass (LMM) was evaluated by means of dual X-ray absorptiometry. Following training, Pmax increased even when muscle mass change due to the growth process was taken into account (Pmax W: + 23 %, W x kg(-1) LMM: + 18%, p < 0.001). The increase in Fopt was principally responsible for such an improvement since no alteration was noticed for Vopt after training. As for Pmax, Fopt was still greater following training when LMM was taken into account (p < 0.01). Furthermore, no changes were noticed for CG for all variables evaluated during the anaerobic test after the study period. Differences between TG and CG regarding Pmax and Fopt were obtained after training only. In conclusion this study highlights the effectiveness of an aerobic training programme to improve the maximal power during short-term exercise in prepubertal children.

Adaptation, Physiological↗

Onset dynamics of reentrant tachycardia and rate-dependent conduction changes in canine ventricular muscle: effects of Na+ and Ca2+ channel blockade.

To show that cycle-length (CL) prolongation occurring at the onset of reentrant tachycardias may be associated with an increase in conduction time (CT), and to investigate the involvement of Na+ and Ca2+ channel activity, reentrant activity was induced by programmed stimulation in thin ventricular muscle slices with a central cryothermal lesion, as documented with 7 to 12 bipolar recordings. We studied the course of the CL measured in successive tachycardia beats, as well as the course of conduction times after abrupt transition from a pacing CL of 1,000 to 400 ms (pacing paradigm). The majority of the tachycardias displayed a dynamic behavior in which CL increased progressively, with an exponential rate constant of 37 +/- 35 beats (mean +/- SD), stabilizing at 325 +/- 67 ms after a total increase of 17 +/- 17 ms. In the pacing paradigm, CT was prolonged from 68 +/- 21 ms to 79 +/- 24 ms according to a biphasic course consisting of an abrupt increase in the first response to 400 ms, followed up by an exponential increase, stabilizing with a rate constant of 18 +/- 23 beats. Lidocaine 5 x 10(-5) mol/L induced an increase in steady-state CT, which was not further modified by adding verapamil 10(-5) mol/L. However, verapamil prolonged the rate constant of the exponential course by 60 +/- 40 beats. Thus, the onset dynamics of reentrant tachycardias share common features with the dynamic behavior of CT in the pacing paradigm, in which both Na+ channel activity and Ca2+-modulated cellular coupling appear to be involved.

Animals↗

Influence of propafenone on resetting and termination of canine atrial flutter.

Previous studies on atrial flutter (AF) presumed that resetting was due to the prematurity effect (PE) in which the stimulated antegrade wavefront travels in the tail of the AF preexisting wavefront. We studied the collision effect (CE) between the AF and the stimulated retrograde wavefronts, its contribution to resetting, and its relationship to AF termination and how they are affected by the Class IC agent propafenone (PPF). A canine model of AF was created using a Y-shaped lesion in the right atrium in 14 dogs (33 +/- 3 kg). Five atrial bipolar electrodes were positioned around the tricuspid valve. In a subsequent set of 11 dogs, we used 16 bipolar electrodes for recording. AF was induced by burst pacing. Single and multiple stimuli were applied to measure conduction time and reset-response curves (RRCs). This was repeated after the administration of PPF (1 mg/kg loading dose for 10 minutes, followed by 1.8 mg/kg/per hour infusion). Three distinct mechanisms were found to contribute to the RRC: the PE, the CE, and heterogeneity. PPF stabilized the RRC, increased significantly the cycle length (CL), the duration of the effective refractory period, as well as the duration of the excitable gap. However, PPF did not alter the duration of the fully excitable portion. We studied 36 annihilations without and 48 with PPF. Transient fibrillation was found in 75% of the episodes without, compared to 22% with PPF. Other types of termination such as conduction block, CL oscillations, and reversal of activation were found for 25% of the episodes without and 78% with PPF. In many cases, conduction block and CL oscillations were associated with a failure of propagation of the stimulated antegrade wavefront in the region of collision. Termination by reversal of activation suggests that propagation was two dimensional and could not be represented by a one dimensional movement. The average coupling interval (in percent of CL), that induced fibrillation was not significantly different from that at which conduction block occurred. This suggests that transient fibrillation is associated with a weak CE rather than with rapid pacing. The CE is amplified by multiple stimuli and PPF. The incidence of transient fibrillation in AF annihilation diminishes with PPF as the CE becomes more important. This suggests that the evaluation of PE and CE in AF may be an indication of the risk of atrial fibrillation.

Action Potentials↗

Cycle length dynamics at the onset of postinfarction ventricular tachycardias induced in canines: dependence on interval-dependent excitation properties of the reentrant substrate.

INTRODUCTION: Postinfarction monomorphic ventricular tachycardias induced by programmed stimulation may display initial cycle length (CL) variations before stabilizing. METHODS AND RESULTS: To show that tachycardia onset dynamics depend on rate-dependent electrical properties of the reentrant substrate, we extracted activation times and maximum negative slopes of local activation complexes (-dV/dt(max)) from 191 unipolar electrograms recorded in the anterior left ventricular wall of anesthetized, 3-day-old infarct canine preparations. Measurements were made of the responses to programmed stimulation, as well as in early and later beats of tachycardias, which displayed either a constant trend in CL (group A, n = 5 preparations) or one in which CL prolongation occurred according to an exponential course before stabilizing (group B, n = 9). Stimulation protocols inducing the tachycardias were more aggressive and their CL was significantly shorter (CL = 159 +/- 24 msec) in group A than in group B (stabilized CL = 206 +/- 34 msec). Reentrant activity occurred in subepicardial areas in which the absolute value of -dV/dt(max) (absolute value(-dV/dtmax)) was heterogeneously depressed (<2 mV/msec). Absolute value(-dV/dtmax) was reduced and activation delay increased in the successive responses to extrastimuli. Further reductions in absolute value(-dV/dtmax) (10% to 23%) were shown to occur between early and later beats in 5 of the 9 tachycardias in group B (no change in the 4 others), and they were associated with localized prolongation of conduction times in reentrant pathways. In contrast, absolute value(-dV/dtmax) improved in all group A tachycardias (7% to 25%). CONCLUSION: This study provides evidence that the onset dynamics of postinfarction ventricular tachycardias are determined by interval-dependent electrical changes occurring in the reentrant substrate.

Animals↗

Quasiperiodic circus movement in a loop model of cardiac tissue: multistability and low dimensional equivalence.

This paper discusses the dynamics of the circus movement around a one-dimensional continuous and uniform loop of model cardiac cells. The membrane ionic currents are represented by a modified Beeler-Reuter formulation. The description of the quasiperiodic regimes initiated in a previous paper is completed and their equivalence with those predicted by an integral-delay model is discussed. The two models differ in the number of quasiperiodic modes of reentry that can be sustained and in the type of bifurcation by which they appear. These differences are the consequences of the modulation of the repolarization phase by diffusion in the ionic model. A modified version of the integral-delay model that includes a spatial averaging in the calculation of the action potential duration is shown to suppress the discrepancies.

Action Potentials↗