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Study of factors affecting the progression and termination of drug induced Torsade de pointes in two dimensional cardiac tissue
Published in Churchill Livingstone Inc.
2017
PMID: 28202194
Volume: 50
   
Issue: 3
Pages: 332 - 341
Abstract
Introduction To study the conditions leading to the initiation and termination of drug induced Torsade de pointes (TdP) along with QT prolongation. Methods A 2D anisotropic transmural section of the ventricular myocardium is modeled using the TP06 equations and the cells are interconnected with gap junction conductances (GJC). The tissue is remodeled by reducing the repolarization reserve (by increasing calcium current (ICaL)) of all cells thus making them vulnerable to development of early after depolarizations (EADs). Results Clinical risk conditions like decreased potassium current (IKr), bradycardia, hypokalemia and short-long-short (SLS) triggering sequences are included in the tissue. A pseudo-electrocardiogram is created to realize the intensity of remodeling required in presence of risk factors to initiate TdP. On initiating TdP, the effect of increasing GJC and decreasing ICaL is shown to terminate a non-self-limiting TdP. Conclusion Without the inclusion of underlying increase in ICaL along with risk factors, TdP cannot be initiated. © 2017 Elsevier Inc.
About the journal
JournalJournal of Electrocardiology
PublisherChurchill Livingstone Inc.
ISSN00220736
Open AccessNo
Concepts (44)
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    Action potential duration
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    Anisotropy
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    Article
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    BRADYCARDIA
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    CALCIUM CURRENT
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    Cardiac muscle
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    CARDIOVASCULAR RISK
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    Conductance
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    Controlled study
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    Disease course
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    DRUG WITHDRAWAL
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    EARLY AFTER DEPOLARIZATION
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    ECG ABNORMALITY
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    Electrocardiogram
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    Gap junction
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    GAP JUNCTION CONDUCTANCE
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    HEART REPOLARIZATION
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    HEART TISSUE
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    HEART VENTRICLE REMODELING
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    Human
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    Human cell
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    Human tissue
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    HYPOKALEMIA
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    LONG QT SYNDROME
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    POTASSIUM CURRENT
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    Priority journal
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    QT PROLONGATION
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    Risk assessment
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    Risk factor
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    TORSADE DES POINTES
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    Biological model
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    Chemically induced
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    Computer simulation
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    Drug effects
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    HEART MUSCLE CONDUCTION SYSTEM
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    Heart rate
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    Pathophysiology
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    TORSADE DES POINTES
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    ANTIARRHYTHMIC AGENT
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    ANTI-ARRHYTHMIA AGENTS
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    HEART CONDUCTION SYSTEM
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    Humans
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    Models, cardiovascular
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    TORSADES DE POINTES