Relative acceleration approach for conduction failure of cardiac excitation propagation on anisotropic curved surfaces

Abstract

In cardiac electrophysiology, it is important to predict the necessary conditions for conduction failure, the failure of the cardiac excitation propagation even in the presence of normal excitable tissue, in high-dimensional anisotropic space because these conditions may provide feasible mechanisms for abnormal excitation propagations such as atrial re-entry and, subsequently, atrial fibrillation even without taking into account the time-dependent refractory region. Some conditions of conduction failure have been studied for anisotropy or simple curved surfaces, but the general conditions on anisotropic curved surfaces (anisotropic and curved surface) remain unknown. To predict and analyze conduction failure on anisotropic curved surfaces, a new analytic approach is proposed, called the relative acceleration approach borrowed from spacetime physics. Motivated by a discrete model of cardiac excitation propagation, this approach is based on the hypothesis that a large relative acceleration can translate to a dramatic increase in the curvature of the wavefront and, subsequently, to conduction failure. For simple anisotropic surfaces, the relative acceleration approach is validated by computational simulations or the previously known results from the kinematics approach. As a practical application, this approach is proposed to provide theoretical explanations of the mechanism of cardiac excitation propagation around the pulmonary vein with anatomically observed anisotropy.