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Cited by 266Cardiac electrophysiology and arrhythmiasCardiac Arrhythmias and TreatmentsCardiac pacing and defibrillation studies

The DOI matches its Crossref record; 69 of the 69 references it cites were found in a registry or an index.

Initiating Reentry: The Role of Nonuniform Anisotropy in Small Circuits

SPACH, MADISON S., JOSEPHSON, MARK E.·1994·Journal of Cardiovascular Electrophysiology
DOI 10.1111/j.1540-8167.1994.tb01157.x
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Abstract

Until recently only two types of media have been considered to provide the nonuniformities necessary to initiate cardiac reentry: (1) continuous isotropic media with intrinsic repolarization inhomogeneities; and (2) continuous isotropic media free of inhomogeneities in which repolarization nonuniformities are introduced transiently. The purpose of this article is to establish cellular coupling as a basis for arrhythmias by placing a new type of inhomogeneity, nonuniform anisotropy due to sparse side-to-side coupling between cells, in an overall perspective with the other nonuniformities that lead to reentry. Review of experimental and theoretical models of reentry leads to the following picture: with slowed conduction, reentrant circuits diminish in size and the nonuniformities necessary for reentry are provided by nonuniform anisotropy. Repolarization nonuniformities create functionally different pathways for reentrant circuits of relatively large size (> 30-50 mm2). Nonuniform anisotropic cellular coupling, which is associated with underlying microfibrosis, makes it possible for reentry to occur in small areas (< 10-15 mm2). A general property found in nonuniform anisotropic bundles is the presence of functionally different pathways in the absence of intrinsic repolarization inhomogeneities--one of fast longitudinal conduction with a longer refractory period, and another of "very slow" transverse conduction with a shorter refractory period. Since it is not known if nonuniform anisotropy exists in the AV node, the best known structure with small reentrant circuits, we performed microscopic extracellular measurements in the AV node of the rabbit. The transitional zone of the AV node was found to have markedly nonuniform anisotropic conduction properties. The analysis provides the view that functionally different pathways of small reentrant circuits, including those of the AV node, need to be reevaluated in terms of the role of nonuniform anisotropic cellular coupling.

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Crossref · 10.1111/j.1540-8167.1994.tb01157.x

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Citations

Cites

Research works printed but not linked: 14

  1. Woodbury JW., 1961, Nervous Inhibition, 124
  2. Krinskii VI, 1966, Spread of excitation in an inhomogeneous medium (state similar to cardiac fibrillation), Biofizika, 11, 676
  3. Gardner PI., 1984, Tachycardias: Mechanism. Diagnosis, Treatment, 29
  4. Mayer AG, 1908, Rhythmical pulsations in scyphomedusae. II, In: Papers from the Tortugas Laboratory of the Carnegie Institution of Washington. Carnegie Institution of Washington. Publication No. 102. Part VII, 1, 113
  5. Mayer AG, 1908, The cause of pulsation, Pulsation Monthly, 73, 481
  6. Wit AL., 1985, Cardiac Electrophysiology and Arrhythmias, 343
  7. Spach MS., 1985, Cardiac Electrophysiology Arrhythmias, 241
  8. Josephson ME, 1993, Clinical Cardiac Electrophysiology. Techniques and Interpretations, 184
  9. Jackman WM, 1991, Participation of atrial myocardium (posterior septum) in AV nodal reentrant tachycardia: Evidence for resetting by atrial extrastimuli, PACE, 14, 646
  10. Hook BG, 1993, Limitations to the concept of discrete AV nodal pathways, J Am Coll Cardiol, 21, 281
  11. Josephson ME, 1992, Clinical Cardiac Electrophysiology. Techniques and Interpretations, 203
  12. Sommer JR., 1979, Handbook of Physiology. Section 2. The Cardiovascular systerm. Volume 1, 169
  13. Dulk K., 1990, Cardiac Electrophysiology. From Cell to Bedside, 934
  14. Fozzard HA, 1979, Handbook of Physiology, Section 2. The Cardiovascular. System, 350

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Metadata

Authors
SPACH, M. S., & JOSEPHSON, M. E.
Affiliations
Duke Medical Center (US)
Corresponding author
SPACH, MADISON S.
Venue
Journal of Cardiovascular Electrophysiology
Publisher
Wiley
Published
1994-02
Volume
5
Issue
2
Pages
182-209
ISSN
  • 1045-3873 (ISSN-L)
  • 1540-8167
DOI
10.1111/j.1540-8167.1994.tb01157.x
OpenAlex
W2050945206
Cited by
266
References
69
Citations by year
2025: 1 · 2024: 3 · 2023: 2 · 2022: 8 · 2021: 7 · 2020: 9 · 2019: 6 · 2018: 6 · 2017: 10 · 2016: 10 · 2015: 8 · 2014: 10 · 2013: 4 · 2012: 7
FWCI
3.63
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4835 d)
Locations
  • Journal of Cardiovascular Electrophysiology (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Heart, Lung, and Blood Institute (R01HL050537, HL50537)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords
cardiac reentry, atrioventricular node, reentrant circuit, slow conduction, refractory period
MeSH terms
Animals, Arrhythmias, Cardiac, Heart, Humans, Refractory Period, Electrophysiological, Tachycardia, Atrioventricular Nodal Reentry, Tachycardia, Sinoatrial Nodal Reentry, Anisotropy

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