PubMed · 248374
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L Schamroth. A study in intracardiac conduction.. https://pubmed.ncbi.nlm.nih.gov/248374/
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Vagal stimulation at precise times in successive cardiac cycles can elicit sinus arrhythmias. Two mechanisms have been identified that can, but do not necessarily, cause these vagally induced sinus arrhythmias. First, changes in cycle length elicited by a given concentration of acetylcholine (ACh) depend on the phase of the pacemaker cell action potential when the ACh binds to muscarinic receptors. Second, acetylcholinesterase degrades ACh rapidly enough for the mean concentration of ACh per cardiac cycle to vary from cycle to cycle. We used a mathematical model of the underlying cellular physiology, to examine whether these mechanisms are responsible for arrhythmogenesis. Computer simulation showed that both mechanisms contribute to the vagally induced sinus arrhythmias.
A computer simulation of ventricular conduction is presented with a discrete element ventricular conduction model. The model is shown to be capable of demonstrating normal ventricular rhythm, including QRS and T-waves, plus a variety of rhythm disturbances including missed beats, electrical alternans and self-sustaining instability with arrhythmias. The morphology of the range of alternans produced bears a strong resemblance to certain clinically recognised arrhythmias.
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