Local Onset of Voltage and Calcium Alternans in the Heart

A beat-to-beat variation in cardiac action potential durations (APD) is a phenomenon known as electrical alternans. Alternans desynchronizes depolarization, increases dispersion of refractoriness and creates a substrate for ventricular fibrillation. In the heart, APD alternans can be accompanied by alternans in intracellular calcium ([Ca²⁺]_i) transients. Recently, we demonstrated experimentally that the onset of APD alternans in the heart is a local phenomenon that undergoes complex spatiotemporal dynamics as pacing rate increases. Moreover, the local onset of APD alternans can be predicted by measuring the restitution properties of periodically paced cardiac tissue. The purpose of this research is to investigate the interplay between local onsets of APD and [Ca²⁺]_i alternans using 2D simulation of action potential model of cardiac myocytes.