Modification of a cylindrical bidomain model for cardiac tissue.

Previous models based on a cylindrical bidomain assumed either that the ratio of intracellular and interstitial conductivities in the principal directions were the same or that there was no radial variation in potential (i.e., a planar front, delta Vm/delta rho = 0). This paper presents a formulation and the expressions for the intracellular, interstitial, extracellular, and transmembrane potentials arising from nonplanar propagation along a cylindrical bundle of cardiac tissue represented as a bidomain with arbitrary anisotropy. For unequal anisotropy, the transmembrane current depends not only on the local change of the transmembrane potential but also on the nature of the transmembrane potential throughout the volume.     

Interstitial potentials and their change with depth into cardiac tissue.

The electrical source strength for an isolated, active, excitable fiber can be taken to be its transmembrane current as an excellent approximation. The transmembrane current can be determined from intracellular potentials only. But for multicellular preparations, particularly cardiac ventricular muscle, the electrical source strength may be changed significantly by the presence of the interstitial potential field. This report examines the size of the interstitial potential field as a function of depth into a semi-infinite tissue structure of cardiac muscle regarded as syncytial. A uniform propagating plane wave of excitation is assumed and the interstitial potential field is found based on consideration of the medium as a continuum (bidomain model). As a whole, the results are inconsistent with any of the limiting cases normally used to represent the volume conductor, and suggest that in only the thinnest of tissue (less than 200 micron) can the interstitial potentials be ignored.     

Current injection into a two-dimensional anisotropic bidomain.

A two-dimensional sheet of anisotropic cardiac tissue is represented with the bidomain model, and the finite element method is used to solve the bidomain equations. When the anisotropy ratios of the intracellular and extracellular spaces are not equal, the injection of current into the tissue induces a transmembrane potential that has a complicated spatial dependence, including adjacent regions of depolarized and hyperpolarized tissue. This behavior may have important implications for the electrical stimulation of cardiac tissue and for defibrillation.     

Measurements of transmembrane potential and magnetic field at the apex of the heart

We studied the transmembrane potential and magnetic fields from electrical activity at the apex of the isolated rabbit heart experimentally using optical mapping and superconducting quantum interference device microscopy, and theoretically using monodomain and bidomain models. The cardiac apex has a complex spiral fiber architecture that plays an important role in the development and propagation of action currents during stimulation at the apex. This spiral fiber orientation contains both radial electric currents that contribute to the electrocardiogram and electrically silent circular currents that cannot be detected by the electrocardiogram but are detectable by their magnetic field, B_z. In our experiments, the transmembrane potential, V_m, was first measured optically and then B_z was measured with a superconducting quantum interference device microscope. Based on a simple model of the spiral structure of the apex, V_m was expected to exhibit circular wave front patterns and B_z to reflect the circular component of the action currents. Although the circular V_m wave fronts were detected, the B_z maps were not as simple as expected. However, we observed a pattern consistent with a tilted axis for the apex spiral fiber geometry. We were able to simulate similar patterns in both a monodomain model of a tilted stack of rings of dipole current and a bidomain model of a tilted stack of spiraled cardiac tissue that was stimulated at the apex. The fact that the spatial pattern of the magnetic data was more complex than the simple circles observed for V_m suggests that the magnetic data contain information that cannot be found electrically.     

Electric and magnetic fields from two-dimensional anisotropic bisyncytia.

Cardiac tissue can be considered macroscopically as a bidomain, anisotropic conductor in which simple depolarization wavefronts produce complex current distributions. Since such distributions may be difficult to measure using electrical techniques, we have developed a mathematical model to determine the feasibility of magnetic localization of these currents. By applying the finite element method to an idealized two-dimensional bisyncytium with anisotropic conductivities, we have calculated the intracellular and extracellular potentials, the current distributions, and the magnetic fields for a circular depolarization wavefront. The calculated magnetic field 1 mm from the tissue is well within the sensitivity of a SQUID magnetometer. Our results show that complex bisyncytial current patterns can be studied magnetically, and these studies should provide valuable insight regarding the electrical anisotropy of cardiac tissue.     

Mechanism of anode break stimulation in the heart.

Anodal stimulation is routinely observed in cardiac tissue, but only recently has a mechanism been proposed. The bidomain cardiac tissue model proposes that virtual cathodes induced at sites distant from the electrode initiate the depolarization. In contrast, none of the existing cardiac action potential models (Luo-Rudy phase I and II, or Oxsoft) predict anodal stimulation at the single-cell level. To determine whether anodal stimulation has a cellular basis, we measured membrane potential and membrane current in mammalian ventricular myocytes by using whole-cell patch clamp. Anode break responses can be readily elicited in single ventricular cells. The basis of this anodal stimulation in single cells is recruitment of the hyperpolarization-activated inward current I(f). The threshold of activation for I(f) is -80 mV in rat cells and -120 mV in guinea pig or canine cells. Persistent I(f) "tail" current upon release of the hyperpolarization drives the transmembrane potential toward the threshold of sodium channels, initiating an action potential. Time-dependent block of the inward rectifier, I(K1), at hyperpolarized potentials decreases membrane conductance and thereby potentiates the ability of I(f) to depolarize the cell on the break of an anodal pulse. Inclusion of I(f), as well as the block and unblock kinetics of I(K1), in the existing Luo-Rudy action potential model faithfully reproduces anode break stimulation. Thus active cellular properties suffice to explain anode break stimulation in cardiac tissue.     

Virtual electrode effects in defibrillation

This modeling study demonstrates that a re-entrant activity in a sheet of myocardium can be extinguished by a defibrillation shock delivered via extracellular point-source electrodes which establish spatially non-uniform applied field. The tissue is represented as a homogeneous bidomain with unequal anisotropy ratios in the cardiac conductivities. Spiral wave re-entry is initiated in the bidomain sheet following an S1-S2 stimulation protocol. The results indicate that the point-source defibrillation shock establishes large-scale changes in transmembrane potential in the tissue (virtual electrodes) that are ‘superimposed’ over regions of various degrees of membrane refractoriness in the myocardium. The close proximity of large-scale shock-induced regions of alternating membrane polarity is central to the ability of the shock to terminate the spiral wave. The new wavefronts generated following anode/cathode break phenomena restrict the spiral wave and render the tissue too refractory to further maintain the re-entry. In contrast, shocks delivered via line electrodes establish, in close proximity to the electrode, changes in transmembrane potential that are of same-sign polarity. These shocks are incapable of terminating the re-entrant activation.     

Interpreting biomagnetic fields of planar wave fronts in cardiac muscle

The recent results of Holzer and co-workers reveal the existence of net currents that flow along the front of a planar wave propagating through cardiac tissue. This is an important contribution toward the better understanding of the physics of biomagnetic fields. However, although the authors claim their results reveal particular bidomain properties, we show in this short letter that the results allow multiple interpretations. For instance, cardiac anisotropy by itself may also explain the existence of a net current along the wave front. Based on our calculations, we suggest additional experiments that would allow distinguishing between these two explanations and thus provide further evidence on the basic physics behind cardiac biomagnetism.     

Virtual electrodes in cardiac tissue: a common mechanism for anodal and cathodal stimulation.

Traditional cable analyses cannot explain complex patterns of excitation in cardiac tissue with unipolar, extracellular anodal, or cathodal stimuli. Epifluorescence imaging of the transmembrane potential during and after stimulation of both refractory and excitable tissue shows distinctive regions of simultaneous depolarization and hyperpolarization during stimulation that act as virtual cathodes and anodes. The results confirm bidomain model predictions that the onset (make) of a stimulus induces propagation from the virtual cathode, whereas stimulus termination (break) induces it from the virtual anode. In make stimulation, the virtual anode can delay activation of the underlying tissue, whereas in break stimulation this occurs under the virtual cathode. Thus make and break stimulations in cardiac tissue have a common mechanism that is the result of differences in the electrical anisotropy of the intracellular and extracellular spaces and provides clear proof of the validity of the bidomain model.     

Analysis of electric field stimulation of single cardiac muscle cells.

Electrical stimulation of cardiac cells by imposed extracellular electric fields results in a transmembrane potential which is highly nonuniform, with one end of the cell depolarized and the other end hyperpolarized along the field direction. To date, the implications of the close proximity of oppositely polarized membranes on excitability have not been explored. In this work we compare the biophysical basis for field stimulation of cells at rest with that for intracellular current injection, using three Luo-Rudy type membrane patches coupled together as a lumped model to represent the cell membrane. Our model shows that cell excitation is a function of the temporal and spatial distribution of ionic currents and transmembrane potential. The extracellular and intracellular forms of stimulation were compared in greater detail for monophasic and symmetric biphasic rectangular pulses, with duration ranging from 0.5 to 10 ms. Strength-duration curves derived for field stimulation show that over a wide range of pulse durations, biphasic waveforms can recruit and activate membrane patches about as effectively as can monophasic waveforms having the same total pulse duration. We find that excitation with biphasic stimulation results from a synergistic, temporal summation of inward currents through the sodium channel in membrane patches at opposite ends of the cell. Furthermore, with both waveform types, a net inward current through the inwardly rectifying potassium channel contributes to initial membrane depolarization. In contrast, models of stimulation by intracellular current injection do not account for the nonuniformity of transmembrane potential and produce substantially different (even contradictory) results for the case of stimulation from rest.     

The effect of simplifying assumptions in the bidomain model of cardiac tissue: application to ST segment shifts during partial ischaemia

In this study various electrical conductivity approximations used in bidomain models of cardiac tissue are considered. Comparisons are based on epicardial surface potential distributions arising from regions of subendocardial ischaemia situated within the cardiac tissue. Approximations studied are a single conductivity bidomain model, an isotropic bidomain model and equal and reciprocal anisotropy ratios both with and without fibre rotation. It is demonstrated both analytically and numerically that the approximations involving a single conductivity bidomain, an isotropic bidomain or equal anisotropy ratios (ignoring fibre rotation) results in identical epicardial potential distributions for all degrees of subendocardial ischaemia. This result is contrary to experimental observations. It is further shown that by assuming reciprocal anisotropy ratios, epicardial potential distributions vary with the degree of subendocardial ischaemia. However, it is concluded that unequal anisotropy ratios must be used to obtain the true character of experimental observations.     

Linear algebraic transformations of the bidomain equations: Implications for numerical methods

A mathematical framework is presented for the treatment of the bidomain equations used to model propagation in cardiac tissue. This framework is independent of the model used to represent membrane ionic currents and incorporates boundary conditions and other constraints. By representing the bidomain equations in the operator notation , various algebraic transformations can be expressed as , where P and Q are linear operators. The authors show how previous work fits into this framework and discuss the implications of various transformation for numerical methods of solution. Although such transformations allow many choices of independent variable, these results emphasize the fundamental importance of the transmembrane potential.     

Genesis of the monophasic action potential: role of interstitial resistance and boundary gradients

The extracellular potential at the site of a mechanical deformation has been shown to resemble the underlying transmembrane action potential, providing a minimally invasive way to access membrane dynamics. The biophysical factors underlying the genesis of this signal, however, are still poorly understood. With the use of data from a recent experimental study in a murine heart, a three-dimensional anisotropic bidomain model of the mouse ventricular free wall was developed to study the currents and potentials resulting from the application of a point mechanical load on cardiac tissue. The applied pressure is assumed to open nonspecific pressure-sensitive channels depolarizing the membrane, leading to monophasic currents at the electrode edge that give rise to the monophasic action potential (MAP). The results show that the magnitude and the time course of the MAP are reproduced only for certain combinations of local or global intracellular and interstitial resistances that form a resting tissue length constant that, if applied over the entire domain, is smaller than that required to match the wave speed. The results suggest that the application of pressure not only causes local depolarization but also changes local tissue properties, both of which appear to play a critical role in the genesis of the MAP.     

Nonlinear effects in subthreshold virtual electrode polarization

Introduction of the virtual electrode polarization (VEP) theory suggested solutions to several century-old puzzles of heart electrophysiology including explanation of the mechanisms of stimulation and defibrillation. Bidomain theory predicts that VEPs should exist at any stimulus strength. Although the presence of VEPs for strong suprathreshold pulses has been well documented, their existence at subthreshold strengths during diastole remains controversial. We studied cardiac membrane polarization produced by subthreshold stimuli in 1) rabbit ventricular muscle using high-resolution fluorescent imaging with the voltage-sensitive dye pyridinium 4-[2-[6-(dibutylamino)-2-naphthalenyl]-ethenyl]-1-(3-sulfopropyl)hydroxide (di-4-ANEPPS) and 2) an active bidomain model with Luo-Rudy ion channel kinetics. Both in vitro and in numero models show that the common dog-bone-shaped VEP is present at any stimulus strength during both systole and diastole. Diastolic subthreshold VEPs exhibited nonlinear properties that were expressed in time-dependent asymmetric reversal of membrane polarization with respect to stimulus polarity. The bidomain model reveals that this asymmetry is due to nonlinear properties of the inward rectifier potassium current. Our results suggest that active ion channel kinetics modulate the transmembrane polarization pattern that is predicted by the linear bidomain model of cardiac syncytium.     

Wavefront propagation in an activation model of the anisotropic cardiac tissue: asymptotic analysis and numerical simulations

In this paper we present a macroscopic model of the excitation process in the myocardium. The composite and anisotropic structure of the cardiac tissue is represented by a bidomain, i.e. a set of two coupled anisotropic media. The model is characterized by a non linear system of two partial differential equations of parabolic and elliptic type. A singular perturbation analysis is carried out to investigate the cardiac potential field and the structure of the moving excitation wavefront. As a consequence the cardiac current sources are approximated by an oblique dipole layer structure and the motion of the wavefront is described by eikonal equations. Finally numerical simulations are carried out in order to analyze some complex phenomena related to the spreading of the wavefront, like the front-front or front-wall collision. The results yielded by the excitation model and the eikonal equations are compared.     

An approximate solution to the periodic bidomain equations in one dimension

An approximate, computationally tractable solution is proposed for the potentials in the bidomain model with periodic intracellular junctions (the periodic bidomain model). This new approach is based on the one-dimensional rigorous spectral method described previously by Trayanova and Pilkington (IEEE Trans. Biomed. Eng., May 1993). The total solution to the one-dimensional periodic bidomain problem is decomposed in the spectral domain into solutions to (1) the single-fiber classical bidomain problem in which the intracellular conductivity value incorporates the average contribution from cytoplasm and junction and (2) the “junctional” potential problem due to the presence of junctions at discrete locations alone. Solving for the junctional term rigorously requires most of the numerical effort in the solution for the periodic bidomain potentials. Here the junctional potential is found approximately with little numerical effort. A comparison between the rigorous and the approximate solutions serves as a justification for the proposed approximate solution procedure. The procedure outlined in this paper is applicable to higher spatial dimensions where both tissue anisotropy and junctional inhomogeneities play a role in establishing the transmembrane potential distribution.     

Active electric properties of cardiac muscle

A model of electrical activity in the heart has been developed that treats the intracellular domain and the extracellular domain as electrical syncytia with anisotropic resistivities (bi-syncytial model). At the microscopic level, propagation is assumed to proceed primarily along the axes of individual cells. Considerations at the macroscopic level relate the transmembrane current to the intracellular and extracellular resistivity and the transmembrane potential. The result is a relationship between instantaneous extracellular potentials and cardiac action potentials.     

Electrically silent magnetic fields.

There has been a significant controversy over the past decade regarding the relative information content of bioelectric and biomagnetic signals. In this paper we present a new, theoretical example of an electrically-silent magnetic field, based on a bidomain model of a cylindrical strand of tissue generalized to include off-diagonal components in the conductivity tensors. The physical interpretation of the off-diagonal components is explained, and analytic expressions for the electrical potential and the magnetic field are found. These expressions show that information not obtainable from electrical potential measurements can be obtained from measurements of the magnetic field in systems with conductivity tensors more complicated than those previously examined.     

The magnetic field of a single axon. A comparison of theory and experiment.

The magnetic field and the transmembrane action potential of a single nerve axon were measured simultaneously. The volume conductor model was used to calculate the magnetic field from the measured action potential, allowing comparison of the model predictions with the experimental data. After analyzing the experiment for all systematic errors, we conclude that the shape of the magnetic field can be accurately predicted from the transmembrane potential and, more importantly, the shape of the transmembrane potential can be calculated from the magnetic field. The data are used to determine ri, the internal resistance per unit length of the axon, to be 19.3 +/- 1.9 k omega mm-1, implying a value for the internal conductivity of 1.44 +/- 0.33 omega -1 m-1. Magnetic measurements are compared with standard bioelectric techniques for studying nerve axons.