Intermittent trapping of spiral waves in a cardiac model.

Abstract

Spiral waves are found in many excitable systems and are thought to play a role in the incoherent electrical activation that underlies cardiac arrhythmias. It is well-known that spiral waves can be permanently trapped by local heterogeneities. In this paper, we demonstrate that spiral waves can also be intermittently trapped by such heterogeneities. Using simulations of a cardiac model in two dimensions, we show that a tissue heterogeneity of sufficient strength or size can result in a spiral wave that is trapped for a few rotations, after which it dislodges and meanders away from the heterogeneity. We also show that these results can be captured by a particle model in which the particle represents the spiral wave tip. For both models, we construct a phase diagram which quantifies which parameter combinations of heterogeneity size and strength result in permanent, intermittent, or no trapping. Our results are consistent with clinical observations in patients with atrial fibrillation that showed that spiral wave reentry can be intermittent.