Correlating the Magnitude and Spatial Gradient of Alternans

OF THESIS CORRELATING THE MAGNITUDE AND SPATIAL GRADIENT OF ALTERNANS Electrical restitution has been shown to inaccurately predict the occurrence of alternans of action potential duration. A new method using the spatial gradient of alternans (SGA) is proposed to predict alternans and cardiac electrical stability. A simulated 1-D strand of tissue was used to compare indexes computed from restitution methods and the SGA method to changes in the amplitude of alternans using different electro-physiological alterations. The SGA method correlated better with changes in the amplitude of alternans than restitution methods for a decrease in the transient outward current (Ito) and conduction velocity. Restitution methods correlated better with changes in the amplitude of alternans than the SGA method when the inward rectifier potassium current (Ik1) and the delayed rectifier potassium current (Ikr) were decreased. Restitution methods and the SGA method correlated well with changes in the amplitude of alternans when the L-type calcium channel current (ICaL) was altered and when Ikr, Ik1, and the sodium/calcium exchange current (INaCa) were increased. The SGA method includes the effect of conduction in tissue and reveals other features that provide advantages in predicting stability over currently used restitution methods.