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Kyoung Jin Lee : A scary, yet interesting, scenario to the fibrillating heart



Alternans, a beat-to-beat temporal alternation in the sequence of heart beats, is a known precursor of the development of cardiac fibrillation, leading to sudden cardiac death. The equally important precursor of cardiac arrhythmias is the rotating spiral wave of electro-mechanical activity, or reentry, on the heart tissue. In this talk, I will show that these two seemingly different phenomena can have a remarkable relationship: In well controlled in-vitro tissue cultures, isotropic populations of rat ventricular myocytes sustaining a temporal rhythm of alternans can support period-2 oscillatory re-entries, and vice versa. These re-entries bear `line defects' across which the phase of local excitation slips rather abruptly by $2\pi$, when a full period-2 cycle of alternans completes in $4\pi$. In other words, the cells belonging to the line defects are period-1 oscillatory whereas all the others in the bulk medium are period-2 oscillatory. We also find that a slowly rotating line defect results in a quasi-periodic like oscillation in the bulk medium. Some key features of these phenomena can be well reproduced in computer simulations of a nonlinear reaction-diffusion model.

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